News | December 09, 2009

Survey Shows Alarming Implications of CMS Echocardiography Cuts

December 9, 2009 – Of the 1,200 cardiologists and cardiovascular ultrasound technicians recently surveyed, 87 percent said the new 2010 CMS Physician Fee Schedule (PFS) could force them to stop accepting Medicare patients, reduce staff or shut down their practice completely.

The American Society of Echocardiography (ASE) released the initial results of its survey about the impact of the cuts on patients and practices. ASE said the cuts could ultimately reduce patient access to echocardiography and other vital services.

“The negative effects of these cuts are immeasurable and numerous,” said Leeanne Etchison, MA, RDCS, an Indiana-based cardiac sonographer. “If fully implemented, the result will be delays in service, higher hospital admissions and probably more deaths due to undiagnosed heart conditions.”

“On many occasions we will do an urgent echo immediately following an evaluation, saving the patient’s time and alleviating the anxiety of uncertainty about a serious heart condition,” said Heriberto Gutierrez, M.D., of Desert Cardiology of Tucson. “With these proposed cuts, this same-day service will not be available, thus prolonging the diagnosis.”

Sixty-three percent of the respondents serve a patient population in which more than half are reimbursed by Medicare Part B. Almost a third of respondents provide services in an area that is rural, medically underserved or both, and the nearest provider of echocardiography services for 74 percent of the respondents is a hospital.

“If private practices close their doors because they can no longer afford to provide these services, patients will be forced to go to the hospital,” said Ben Byrd, M.D., advocacy chair of ASE. “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.”

The survey showed that for the echocardiography service providers affected most directly by the PFS payment cuts, the actions currently being considered most often are:

• 64 percent would delay the purchase of echo equipment
• 56 percent would lay off sonographers or other staff
• 53 percent would reduce staff salaries
• 47 percent might reduce staff benefits, such as 401K programs or healthcare
• 23 percent would refrain from accepting Medicare patients for any services
• 19 percent are considering closing a satellite office(s) or have already closed a satellite office(s) - 60 percent of these are located in rural areas

For those echocardiography service providers who will be indirectly affected by the payment cuts (those who receive payment through the Hospital Outpatient Payment System), the survey showed anticipated outcomes would include:

• Increased workload (74 percent)
• Longer wait times for patients (67 percent)
• Lengthened turnaround time for reports (44 percent)
• Increased overtime for staff or the need to hire additional cardiac sonographers (43 percent)

ASE collected regional anecdotes from almost 200 members who will be affected by the cuts. Many provided examples of patients who might have died had in-office echocardiography services not been available.

For more information: SeeMyHeart.org.

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