“Whether a specialty experienced a per beneficiary reimbursement decline or not was a function of changes in healthcare consumption per beneficiary and how that compared with inflation-adjusted declines in the conversion factor” stated Gregory Nicola, MD, Executive Leadership, Hackensack Radiology Group and Chair, ACR Economics Commission. “We found that specialties would have to increase their volume of services by 50.7% per beneficiary to maintain the same per beneficiary reimbursement over the 2005-2021 period.”
“While reducing physician payments can help to contain Medicare expenditures, it may also lead to unintended consequences for patients” stated Joshua Hirsch, MD, Neiman Institute Affiliate Senior Research Fellow and Vice Chair Procedural Services, Massachusetts General Hospital. “Continued decline of Medicare reimbursement relative to reimbursement by private insurance incentivizes providers to favor privately-insured patients. Our study pinpoints the extent to which real decreases in reimbursement are occurring despite greater consumption of care. We hope this study will motivate policy makers to find a solution that inures to the benefit of the Medicare insured population who are at risk for diminishing access to care.”
The authors cited the Boards of Trustees of the Medicare Hospital Insurance and Supplement Medical Insurance Trust Funds, which have reported the substantial uncertainty in the adequacy of Medicare payments given current law. As such, the Boards anticipate significant future access issues if current trends are not mitigated (2023 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds).
About the Harvey L. Neiman Health Policy Institute
The Harvey L. Neiman Health Policy Institute is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care. Visit us at www.neimanhpi.org and follow us on Twitter, LinkedIn and Facebook.
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