Echo survey reveals fears of practice changes due to CMS cuts

Initial results of a survey conducted by the American Society of Echocardiography (ASE) found that 87 percent of cardiologists and cardiovascular ultrasound technicians feared that the 2010 Center for Medicaid & Medicare Services (CMS) Physician Fee Schedule (PFS) could trigger staff reductions, end their practice or require them to stop accepting Medicare patients.

The survey comes as a result of CMS releasing the PFS final rules Oct. 30, which revealed cuts of 10 to 40 percent to cardiology services over the next four years. In addition, the agency proposes that it “will reduce the conversion factor for services on or after Jan. 1, 2010, by 21.2 percent rather than the -21.5 percent projected in the proposed rule.”

As of press time, the U.S. House of Representatives had repealed this cut. The legislation, if passed by the Senate, would eliminate all SGR debt accumulated over the years because of temporary, unfunded fixes. It also would establish updates based on two new targets with significantly higher spending growth allowances than the SGR.

The survey of 1,200 cardiologists and cardiovascular ultrasound technicians, 64 percent of the echocardiography service providers affected most directly by the PFS payment cuts said they will be considering delaying the purchase of echo equipment, while 56 percent said they are considering staff layoffs and 53 percent reducing staff salaries.

Of the service providers who receive payments from the Hospital Outpatient Prospective Payment System (HOPPS) and who are indirectly affected by the cuts, 74 percent said they anticipate an increased workload, 67 percent expected longer wait times for patients and 43 percent expect increased overtime for staff and the need for additional cardiac sonographers.

“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, MD, 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.”

Of the participants, 74 percent noted that the nearest provider of echocardiography services is a hospital, and almost a third reported that they provide service in a rural area, medically underserved area or both. In addition, 63 percent of the survey respondents noted that they serve a patient population where more than half are reimbursed by Medicare Part B.

According to survey participants, the new fee schedule could jeopardize patient care by restricting access to echocardiography and other services if practices are forced to reduce staff numbers or close practices.

Survey input ended yesterday, and ASE said that results will be used to illustrate the harmful effects the cuts would have on healthcare professionals and their patients to legislators and CMS.