Spending by Commercial Insurers on Chemotherapy Based on Site of Care, 2004-2014

Abstract

The impact of price variation because of the site of care—receiving treatment in a physician office vs a hospital outpatient department (HOPD)—is an important driver of health care spending.¹ While patients may receive the same treatment in either setting, insurers typically reimburse payments to HOPDs at a higher rate than to physician offices. Hospitals justify this payment difference because they incur higher overhead costs and treat more medically complex patient populations.^1,2