Medicare: Increasing Hospital-Physician Consolidation Highlights Need For Payment Reform, GAO-16-189

In this report released in December 2015, the Government Accountability Office (GAO) analyzed trends in hospital vertical consolidation and the potential impact on the Medicare program. Hospital vertical consolidation was defined as hospital ownership of a physician practice or employment of physicians. Medicare reimbursements for E/M services provided in an outpatient setting are lower than for evaluation and management (E/M) services provided in a hospital outpatient department (HOPD) setting. In 2013, the total Medicare payment rate for a mid-level E/M office visit for an established patient was $51 higher when the service was performed in an . . .