News: In-hospital outpatient cancer patients more likely to be lower-income, report suggests

Medicare patients seeking treatment at hospital outpatient departments (HOPD) are more likely to be sicker, more complex, and poorer than Medicare patients seeking treatment at independent physician offices (IPO), according to a new American Hospital Association (AHA) report.

The authors of the report examined Medicare patients from the fourth quarter of 2018 to the second quarter of 2024. The patients examined in the cohort had at least one HOPD or IPO visit and a continuous enrollment in Medicare fee-for-service Part A and B.

According to the report, HOPD Medicare cancer patients, when compared with their IPO counterparts, were more likely to be:

• Under 65 and disabled (54% more likely)
• Dually eligible (61% more likely)
• From lower-income areas and rural counties (60% more likely)
• Burdened with more severe chronic conditions
• Previously hospitalized
• Previously cared for in an emergency department

“Current Medicare payment rates appropriately recognize the fundamental differences between patient care delivered in hospital outpatient departments compared to other settings, including around-the-clock services and emergency care,” said AHA President and CEO Rick Pollack in a press release.

“However,” he continued, “efforts to expand site-neutral payment cuts disregard the realities of our health care system and will result in limiting or eliminating critical hospital-based care. The result will be increased wait times and reduced access to care for all patients.”

Editor’s note: To read the AHA report, click here. To read the AHA CEO statement, click here.