Imaging Cuts in Proposed 2013 Medicare Fee Schedule Rule Potentially Dangerous, Unfounded and Unnecessary
Reston, Va. (July 9, 2012) – Extreme cuts to funding for medical imaging scans in the Medicare Fee Schedule Proposed Rule — particularly an expansion of the multiple procedure payment reduction for interpretation of scans performed on the same patient, in the same session on the same day, to all providers in the same practice or hospital — are unnecessary, unfounded and undermine care for the most sick or injured seniors.
“These cuts affect primarily those suffering from multiple trauma or heart attacks, stroke patients and those with widespread cancer — all of whom often require multiple imaging scans to survive. Interpretation of these scans often requires expertise of different physicians. These are not screening exams for otherwise healthy people. They are for people with immediately life threatening illnesses or injuries. These cuts discourage doctors from working as a team and pull the rug out from under the very physicians working to save these people’s lives,” said Paul Ellenbogen, MD, FACR, chair of the American College of Radiology Board of Chancellors.
CMS expanded not only the number of physicians affected by this policy, but the number of exams, based on a theory that has been medically debunked. There is no publicly available evidence to support a 25 percent reduction to physician interpretation payments in general. A 2011 study proves that any efficiencies in the multiple procedure setting are highly variable and, at most, total one-fifth of what CMS contends. No efficiencies in care support a funding cut when different physicians in a group practice interpret separate imaging scans for the same patient.
“These cuts are an expansion of a bad policy that lawmakers have already lined up against. More than 250 members of the House are already co-sponsors of the Diagnostic Imaging Services Access Protection Act (H.R. 3269) which would block the original multiple procedure payment reduction on which these are based. Medicare funding for imaging scans has already been slashed $5 billion since 2007. We call on lawmakers to protect care for the most vulnerable of our nation’s seniors by updating the bill to address these cuts and passing H.R. 3269 with all haste,” said Dr. Ellenbogen.
Further cuts to imaging do little, if anything to safely bend the Medicare cost curve. Imaging use in Medicare is down since 2008. Medicare spending on scans is at the same level it was in 2003. Imaging is also the slowest growing of all physician services among privately insured Americans according to the Health Care Cost Institute. A multitude of studies show that medical imaging exams are directly linked to greater life expectancy, declines in mortality rates, and are generally safer and less expensive than the invasive procedures that they replace. Scans also reduce the number of invasive surgeries, unnecessary hospital admissions and length of hospital stays.
“A national poll of 1,000 registered voters has already shown that nearly 90 percent of Americans believe more imaging cuts will affect early detection of medical conditions and diseases. A full 70 percent of Americans oppose further Medicare cuts to medical imaging. It’s time to stop undermining the future of healthcare and accept that imaging saves lives, resources and time. All of us needing care will be better for it,” said Ellenbogen.
To arrange an interview with an ACR spokesperson, contact Shawn Farley at 703-648-8936 or PR@acr.org.