Feature | July 16, 2012

ACC, ACR Scorn Proposed Medicare Physician Fee Schedule

July 16, 2012 — The American College of Cardiology (ACC) and the American College of Radiology (ACR) are warning that the extreme cuts to funding for medical imaging scans in the 2013 Medicare Physician Fee Schedule Proposed Rule are unnecessary, unfounded and will undermine patient care.

The proposed rule calls for an expansion of the multiple procedure payment reductions 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. The Centers for Medicare and Medicaid (CMS) expanded both the number of physicians affected by this policy and the number of exams. ACR issued a statement explaining 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, ACR stated.

“The proposed Medicare physician fee schedule rule undeniably has negative consequences for physicians and their patients," said ACC President William Zoghbi, M.D., FACC. "In addition to the mandated 27 percent sustainable growth rate (SGR) cut, CMS proposes an additional 3 percent reduction for cardiovascular services.

“Part of these cuts result from a misguided policy that will reduce payment if more than one diagnostic cardiovascular service is provided on the same day. This policy disadvantages physicians who aim for efficiency and reduces payments based on a misguided understanding of how different services, such as echocardiography and SPECT imaging, are from one another.  Furthermore, it would lead to a major inconvenience to patients. We aim to demonstrate to CMS why this proposal would not be beneficial.   

“Congress has until the end of 2013 to come up with a solution to the flawed SGR payment formula and to prevent next year’s SGR-based cut, currently estimated at 27 percent, from taking effect. The need to fix SGR continues to be a top priority in the United States.

“With the Accountable Care Act (ACA) ruling behind us, it's time to continue down the path to healthcare reform. The American College of Cardiology’s goal is a sustainable system that rewards quality and focuses on patient-centered care.  While this rule takes steps in that direction, it is undermined by old ways of cutting payments without improving quality.”

The ACR also issued a strongly worded statement about the cuts.

“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," said Paul Ellenbogen, M.D., FACR, chair of the American College of Radiology Board of Chancellors. "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."

For more information: www.cardiosource.org/ACC

Related Content

News | Business| February 23, 2017
The Software & Information Industry Association recently announced the 2017 Jesse H. Neal Award finalists, with...
coordinated heart attack care, Ontario STEMI Bypass Protocol, Canada
News | Cath Lab| February 22, 2017
Two new Ontario-wide heart attack protocols for paramedic services and emergency departments that aim to saves lives...
transradial approach, same-day cardiac procedures, radial access, $300 million annual savings, JACC Cardiovascular Interventions study
News | Radial Access| February 22, 2017
If hospitals can perform more transradial, same-day percutaneous coronary intervention (PCI), hospitals across the U.S...
TrumpCare
News | Business| February 20, 2017
According to Vertess, an international healthcare-focused M + A advisory firm with expertise in diverse healthcare and...
Cardinal Health survey, hospital staff, supply chain management, quality of care
News | Inventory Management| February 15, 2017
Better hospital supply chain management leads to better quality of care and supports patient safety, according to a new...
heart team, hybird OR, structural heart team

The heart team approach was first used on a large scale in the CoreValve and Sapien TAVR trials and helped lead to excellent outcomes in high-risk patients.

Feature | Hybrid OR| February 15, 2017 | Dave Fornell
In the current era of healthcare reform and the push toward evidence-based medicine to both lower costs and improve p
Rep. Tom Price, confirmed, Health and Human Services, HHS, new secretary
News | Business| February 10, 2017 | Jeff Zagoudis
Rep. Tom Price was confirmed by the U.S. Senate as the new secretary of the Department of Health and Human Services (...
Innovaccer, MIPS Platform, reporting and performance optimization, Datashop
Technology | Business| February 07, 2017
Healthcare analytics company Innovaccer Inc. announced the launch of its holistic MIPS Platform designed to enable...
Inventory management, analytics software, cardiology, cath lab
Sponsored Content | Case Study | Inventory Management| February 07, 2017
The supply chain can serve as a critical strategic asset when addressing important initiatives tied to managing costs
Sponsored Content | Webinar | Inventory Management| February 01, 2017
How healthy is your cath lab supply chain?
Overlay Init