MedPAC Proposes Imaging Payment Cuts

The Medicare Payment Advisory Commission (MedPAC) has proposed reimbursement cuts to radiology of almost 4%, while increasing payments for services such as clinician and hospital outpatient visits by 10%.

The recommendation in MedPAC’s June report to Congress is prompted by the commission’s concern that certain health services such as imaging exams, procedures, and tests are overvalued when compared with patient evaluation and management services, according to MedPAC Executive Director Jim Mathews, PhD.

“We feel that although the effort to identify and correct mis-valued services has made incremental improvements to physician payment accuracy in the fee schedule, these improvements have been largely overshadowed by what we call ‘passive devaluation’ of evaluation and management services,” he said in a telephone press conference held on June 15th.

To remedy the situation, MedPAC suggested that Congress implement a one-time adjustment to the Medicare Physician Fee Schedule, increasing evaluation and management payment rates by 10% and reducing payment rates for other services by 3.8%. This scenario would boost payments for evaluation and management services by $2.4 billion, with endocrinology, rheumatology, and family practice seeing the highest proportional increases, while diagnostic radiology, pathology, and physical and occupational therapy would experience payment cuts, according to the report.  But these cuts would have to be combined with a longer-range effort, the commission noted.

MedPAC also addressed what it sees as a need to change the way healthcare quality is measured, urging CMS to adopt smaller, population-based measures such as outcomes, patient experience, and value of service to assess quality of care.

MedPAC reported that current quality measurements are too process-based and they do not accurately evaluate the quality of care. MedPAC recommends that Medicare use a small set of outcomes-based and patient experience measures that should be scored against absolute targets rather than the currently used QPP ‘tournament’ model in which providers are scored relative to each other.

As always, ADVOCATE will keep you up to date on this and all issues impacting radiology as they become available.

Best regards,
Kirk Reinitz, CPA