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Survey results suggest concern among imaging specialists regarding proposed cuts to physician fee schedule
Specialists fear changes may force cost-cutting measures like delayed equipment purchase, staff layoffs and reduced availability of tests.
Impending changes to the 2010 Center for Medicaid Services Physician Fee Schedule have many cardiologists concerned, according to survey results released by the American Society of Echocardiography.
According to the responses of 1,200 cardiologists and cardiovascular ultrasound technicians, 87% expressed concern that the new fee schedule could potentially force them to stop accepting patients using Medicare, limit their services or shut down their practices. More than half of the respondents (63%) served a patient population in which more than half are reimbursed by Medicare Part B. Almost one-third of survey respondents provided services in either rural areas or other areas that were medically underserved.
Further analysis of the survey results revealed that 64% of respondents who would be directly affected by the cuts said they would be forced to consider delaying the purchase of echocardiography equipment, as well as lay off staff (56%) and reduce salaries (53%). Nearly half of the respondents also indicated that a reduction in staff benefits (47%) would be considered in their practices. The survey results also showed that in echocardiography service providers indirectly affected by the payment cuts, practitioners anticipated increased workload and longer wait times for patients, as well as lengthened turnaround time or reports and a need for increased overtime for additional cardiac sonographers.
“If private practices close their doors because they can no longer afford these services, patients will be forced to go to the hospital,” Ben Byrd, MD, advocacy chair of the American Society of Echocardiography, said in a press release. “This could be a life or death situation for Medicare patients, especially those in rural areas who can’t get to a hospital in a timely manner.”
During roughly the same time period in which Medicare has existed, echocardiography has become a ubiquitous and indispensable tool for the evaluation of heart disease patients, perhaps as important to the cardiologist as the stethoscope and the electrocardiogram. Recent drastic cuts in the CMS Physician Fee Schedule will make provision of echocardiograms in many physician offices economically unsustainable. Echocardiographic services, even for outpatients, will likely be shifted to the hospital, where charges and costs are much higher and inpatients take priority (as they should). It can be expected that access to echocardiograms will be less timely, less convenient and will increase patient co-pays. Patients in rural areas and those with limited financial resources may simply not have access to this very valuable noninvasive diagnostic tool. The unintended consequences of this CMS policy will be to promote hospital-based echocardiography at the expense of ambulatory, community-based services, while effective and efficient health care is now moving in the opposite direction.
Cardiology Today Section Editor