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Alliance Offers Recommendations to Keep Patients at Center of Payment-Related Decision-Making

Published September 12, 2023

On Monday, September 11, the Alliance for Aging Research responded to a request for comment from the Centers for Medicare and Medicaid Services (CMS) on the current year (CY) 2024 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule. The letter noted several key concerns and recommendations for the proposed rule and emphasized the need to keep patients at the center of any payment-related decision making.

In the letter, the Alliance expressed support for CMS’s efforts to alleviate the financial burden on hospitals and incentivize the provision of valuable diagnostic tests, particularly those related to Alzheimer’s disease (AD). The availability of FDA-approved radiopharmaceuticals has significantly improved the accuracy of AD diagnosis and patient management. Unfortunately, current payment policy fails to adequately cover the costs incurred by hospitals when performing these tests, presenting a significant financial challenge. The Alliance stressed the importance of decoupling payments for PET scans related to AD from other radiopharmaceuticals in order to ensure that providers are adequately reimbursed for providing more expensive services. This change would facilitate broader access to these crucial diagnostics, particularly in anticipation of the rising demand caused by new disease-modifying treatments for AD.

Additionally, the letter acknowledged the substantial challenges faced by rural hospitals, including labor shortages, supply cost pressures, the looming threat of closures, and the enduring impact of the COVID-19 pandemic. In response, the Alliance urged CMS to address these pressing issues by implementing higher payment rates for CY 2024. This action would ensure equitable healthcare access for older adults in rural communities.

These recommendations aim to enhance patient care and provide much-needed support to healthcare providers, especially those in rural areas, as they navigate the challenges of effectively serving an aging population.

Read the full letter.

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