New Findings from Brown University School of Public Health in the Area of Managed Care Reported (Site-neutral payment for routine services could save commercial purchasers and patients billions): Managed Care

2026 JAN 19 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Managed Care. According to news reporting originating from Providence, Rhode Island, by NewsRx correspondents, research stated, “Medicare and commercial payers pay more for services delivered in hospital outpatient departments than in physicians’ offices or ambulatory surgery centers. These ‘site-of-care’ payment differentials contribute to rising health care spending and drive hospital acquisition of physician practices.”

Financial support for this research came from Arnold Ventures.

Our news editors obtained a quote from the research from the Brown University School of Public Health, “Because many non-hospital settings can provide equivalent or higher-quality care at lower costs, site-neutral payment has gained traction in Medicare, with the potential to save patients and taxpayers billions. A growing number of states are exploring similar policies in the commercial market by capping payments for routine services at a percentage of the Medicare payment in non-hospital settings. The impact of such policies for commercial purchasers and patients has not yet been modeled. This study uses 2022 commercial claims data from the Health Care Cost Institute and estimates potential savings by capping prices for 2561 routine services (Current Procedural Terminology codes) at 150% of the Medicare payment in hospital, office, and ambulatory surgery center settings. Site-neutral payment for commercial purchasers and patients could save $10.8 billion across 48 states and Washington, D.C. State level aggregate hospital operating margins would decline modestly.”

According to the news editors, the research concluded: “Site-neutral policies could yield substantial savings but require ongoing monitoring for unintended effects.”

This research has been peer-reviewed.

For more information on this research see: Site-neutral payment for routine services could save commercial purchasers and patients billions. Health Affairs Scholar, 2025;3(12).

The news editors report that additional information may be obtained by contacting Haroon Janjua, Dept. of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, United States. Additional authors for this research include Roslyn C. Murray and Christopher M. Whaley.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1093/haschl/qxaf241. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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