Medicare cuts expected to limit access for stroke and aneurysm patients, could cause some practices to close
The 2021 Medicare Physician Fee Schedule (MPFS) includes “inexcusable” reimbursement cuts that could have a significant impact on patient access to stroke and aneurysm care, according to a new analysis published in the Journal of NeuroInterventional Surgery.
CMS released the MPFS final rule on Dec. 1, and numerous healthcare organizations—including several in the cardiology space—have spoken out about how these cuts will impact both healthcare providers and the patients they serve.
CMS Administrator Seema Verma, meanwhile, has described the cuts as something “that happens all the time.”
The authors of the JNIS analysis explored how CMS determines reimbursement payments and how the last three years resulted in a conversion factor reduction of nearly 11% for so many physicians in 2021. Medicare payments to physicians have not kept up with inflation rates in the United States, the team said, adding that the conversion factor has been headed in the wrong direction for many years now.
The authors also wrote that “shortcomings in healthcare delivery in the United States” have already been highlighted by the ongoing COVID-19 pandemic. With these cuts in place, they argued, many practices may not survive an already-challenging time.
“Absent suspension of the budget neutrality requirement, we fear the access challenges that might accompany such a draconian change.” wrote first author Theresa H. Nguyen, MD, a radiologist at Ochsner Medical System in New Orleans, and colleagues.
The analysis also includes a prediction that private insurers will follow the example set by CMS and reduce their own reimbursement rates.
“This rule originates in Medicare, but we know that private insurers often base their own rates on those set by CMS,” Felipe Albuquerque, MD, JNIS editor-in-chief, said in a statement. “Together, that represents about 80% of the patient population. Some practices will not be able to withstand that level of reimbursement reduction for very long.”
The full JNIS assessment is available here.
A CMS fact sheet about the final rule can be read here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.