Which aspect of payment does the Outpatient Prospective Payment System (OPPS) primarily influence?

The Outpatient Prospective Payment System (OPPS) primarily influences outpatient services provided by healthcare facilities. OPPS is a payment methodology established by the Centers for Medicare & Medicaid Services (CMS) that determines how hospitals are reimbursed for outpatient care they provide to patients. Under this system, services are grouped into Ambulatory Payment Classifications (APCs), which package payments based on the clinical and resource similarities of the services rendered.

The structure of OPPS incentivizes efficiency and cost-effectiveness in outpatient care. Because OPPS focuses specifically on outpatient services, it streamlines reimbursement processes for those types of care while ensuring that providers are compensated fairly based on the complexity and resources associated with the services that are delivered. This system is critical in the broader landscape of healthcare reimbursement, as it addresses the unique needs and characteristics of outpatient care, setting it apart from inpatient, home healthcare, or long-term care payment methodologies.