Medicare is in trouble—and that’s bad news for radiologists, patients

The American College of Radiology (ACR) worked alongside many other organizations to help get Congress to repeal Medicare’s sustainable growth rate (SGR) formula in 2015. However, as Rakesh A. Shah, MD, wrote in a recent commentary in the Journal of the American College of Radiology, that victory did not change the fact that healthcare costs for an aging population are rising faster than the rest of the U.S. economy.

“According to Congressional Budget Office (CBO) projections, net Medicare spending will grow from 2.9 percent of GDP in 2018 to 6.1 percent in 2047 and be a major driver of the federal debt moving forward,” Shah, of NYU Winthrop Hospital in Mineola, New York, wrote. “The much lauded doc fix was not actually a fix at all, rather a decision to kick the can down the road, at a cost of over 500 billion dollars in borrowing. That can will soon be coming back into view and may be even more difficult to kick again, with serious implications for our profession.”

So how bad is it? Shah noted that Medicare’s Hospital Insurance (HI) trust fund, “the source of reimbursements to hospitals for the technical component of radiology procedures performed on hospital patients,” is projected to start running out of money sooner than later. In less than a decade, it won’t be able to pay 100 percent of projected liabilities.

The shape of the Supplementary Medical insurance fund, home to Medicare Part B payments made to radiologists, should also concern radiologists. Shah wrote that “those parts of Medicare funded by general tax revenues (which would include the major funding source for Part B payments to radiologists) remain at a very real risk of cuts.”

This could all spell trouble for radiology as a whole. Hospital radiology departments would be significantly impacted if they could not depend on the HI trust fund for reimbursements, and cuts to Medicare Part B payments “would amount to substantial total annual reductions in reimbursements to radiologists," Shah wrote.

The SGR formula was successfully repealed, Shah concluded, and now it’s time for the specialty to work together to defend Medicare—before it is too late.

“We need to pressure politicians to make painful choices to preserve the solvency of Medicare now and not later, when such choices may be much more difficult,” Shah wrote. “The time for us to act to save Medicare is now.”

Michael Walter
Michael Walter, Managing Editor

Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.

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