Rural Health Executive Order, Physician Fee Schedule and Hospital Outpatient Payment Proposals Lay Groundwork for Medicare in 2021 and Beyond

August 4, 2020

On August 3, President Trump signed an Executive Order (EO) on Improving Rural Health and Telehealth Access aimed at increasing access to healthcare services in rural areas. The EO aims to expand certain temporary regulatory flexibilities beyond the COVID-19 public health emergency, create a new payment model to help rural providers move to value-based arrangements, improve telecommunications infrastructure, and reduce regulatory burdens for rural providers.

The 2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule was also released on August 3. To maintain budget neutrality within the fee schedule, the proposed Calendar Year (CY) 2021 MPFS conversion factor is $32.26, a decrease of $3.83 from the CY 2020 PFS conversion factor of $36.09. Despite this significant decrease, CMS estimates a 14% increase in payments to the hematology/oncology specialties and a decrease of 6% to radiation oncology.

On August 4, the 2021 Hospital Outpatient Prospective Payment System Proposed Rule was released. This proposed rule would revise the Medicare hospital outpatient prospective payment system and the Medicare ambulatory surgical center payment system for CY 2021.

ASCO is analyzing the full impact each of these actions could have on oncology patients, physicians, and practices. Stay tuned to ASCO in Action for analysis and updates to come.