‘Grave concern’: Radiologist reimbursement expected to plummet after CMS clinical labor wage update

Radiologists and other providers are expressing “grave concern” around plans to boost pay for clinical labor staff, a move advocates say will result in drastically reduced reimbursement for the specialty.

The proposal is part of the 2022 Medicare Physician Fee Schedule, released in July. CMS wants to update wages for clinical labor staffers such as mammography technologists or angiography techs. But these practice expense components are subject to budget neutrality, meaning increased spending in one place requires cuts elsewhere. As such, interventional radiology, radiation oncology and other specialties with high medical supply costs and lower spending on clinical labor positions could face significant reimbursement reductions next year, experts predict.

The services most impacted by this decision are used to treat diseases that disproportionately impact patients of color, the Society of Interventional Radiology warned Friday.

“As a result, the profound cuts will negatively affect health equity in communities who have already been particularly hard hit by the COVID-19 pandemic,” SIR said in a statement.

The Society of Interventional Radiology is working alongside the American College of Radiology, American Medical Association and the CardioVascular Coalition to fight these changes. In its own update issued Aug. 12, ACR said the groups are exploring “all regulatory and legislative options to protect radiology practices and access to quality care.”

CMS estimates cuts attributed to periodic labor pricing updates would land at 5% in interventional radiology and 1% for radiology. That’s in addition to a 9% cut for IR and 2% in radiology because of adjustments in the conversion factor used to calculate reimbursement, mandated sequestration and cuts to practice expense values. SIR said the proposed reductions represent a “perfect storm,” resulting from the feds’ failure to keep labor rates current with inflation.

The CardioVascular Coalition—a group representing physicians, other providers, advocates and manufacturers—expressed “grave concern” tied to anticipated 20% payment cuts to revascularization services in 2022. Updating clinical labor data in the CMS database “makes sense,” the group said, and every specialty should see increases to resources based on this change. However, these gains should not come at the expense of access to such services to treat peripheral artery disease.

“These impacts will have profoundly negative effects on health equity,” the coalition said in a statement. “The decrease in access to revascularization services could lead to higher amputation rates and exacerbate inequities that already exist, particularly in America’s communities of color.”

The Society of Interventional Radiology and others are urging Congress and CMS to reverse the cuts, suspend sequestration, and maintain the COVID-related increase to the conversion factor. SIR said this would ensure that rad reimbursement “better reflects the real cost of healthcare in a pandemic world.”

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