Medicare Cutbacks Threaten Cardiac Care Access for Rural Patients
October 12, 2009 – Medicare regulatory changes expected to be finalized in November pose a threat to 80 million American patients suffering from heart disease, especially for the nearly one in four over the age of 65 living in rural areas, according to the medical lobby group Guarding Hearts Alliance.
Many cardiologists who operate in rural areas believe the proposal will force them to close their outreach offices completely since many of these operations run at a fiscal loss but offer an important service to remote communities.
"We currently provide cardiac services to nine remote clinics two to four times each month," said Joe Stevenson, M.D., president of Sierra Nevada Cardiology Associates in Reno, Nev. "If these Medicare cuts go through, we will not be able to provide diagnostic echocardiography services on-site at those locations. That will mean our rural patients will have to drive up to 400 miles round trip to obtain these critical imaging tests. Some of them just won't be able or willing to do that. And since 50 percent of patients experience their first cardiac disease symptoms as a heart attack, the lack of access to diagnostic tests will put their lives at tremendous risk."
At issue is the amount Medicare, a federal program that helps people 65 or older pay health care costs, reimburses cardiologists for lifesaving diagnostic testing. Beginning in January 2010, reimbursement rates could be slashed in some cases by an additional 40 percent for imaging and other diagnostic tools cardiologists use.
Guarding Hearts Alliance said cardiologists, especially in rural areas, will have to stop using these tools and instead send their patients to get these tests at hospitals. Many rural patients will face long distance travel to hospitals, out-of-pocket costs that are as much as five times higher than in-office copays and wait times for tests and test results that will take days, not hours as currently is the case when obtained in the cardiologist's office.
Guarding Hearts Alliance is fighting Washington over the proposal, which the group says is based on questionable data gathered in 2006 via a study it considers statistically invalid, which used data from only 55 cardiologists.
The Guarding Hearts Alliance is a partnership representing more than 23,000 cardiologists across the country, all of whom are strongly in favor of Medicare regulations and healthcare reform initiatives that put patients first in preserving access to quality cardiac care. Administered through the Cardiology Advocacy Alliance, the group is concerned about potential changes that could inadvertently endanger patient lives. Such issues as imaging equipment utilization and reimbursement fee schedules might sound like they would generate simple shifts in business practices, but the group says they represent a potential threat to access to lifesaving technology that serve the range of rural Medicare recipients to privately insured urban residences alike.
For more information: www.GuardingHeartsAlliance.org.
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