Cardiologists face 29% Medicare cut, Heart Surgeons slashed by 58%
TL/DR –
From 2005 to 2021, 16 healthcare specialties, including cardiology and surgery, saw significant drops in reimbursements when adjusted for inflation, according to a study by Christensen et al. During the same period, payments to nonphysicians such as nurse practitioners increased by 206.5%, while payments to limited-license physicians and medical suppliers also rose. Joshua Hirsch from the Neiman Institute warns that continuing the downward trend in Medicare reimbursement could lead to providers prioritizing privately insured patients, potentially jeopardizing access to care for Medicare-insured patients.
Decline in Reimbursement Rates for Healthcare Specialties from 2005 to 2021
A study by Christensen et al. revealed that Medicare reimbursements for 16 healthcare specialties, including cardiology, thoracic surgery, radiology, psychiatry, and internal medicine, have been on the decline from 2005 to 2021, once inflation is considered. Cardiac surgery saw the steepest drop at 57.6%, followed by thoracic surgery at 41.5% and cardiology at 29%.
No Increase in Relative Value Units for Some Specialties
Among the 16 specialties, general surgery, thoracic surgery, and cardiac surgery experienced reimbursement declines without an associated rise in relative value units (RVUs).
Rise in Payments to Nonphysician and Limited-License Physicians
The study also noted a significant rise in payments to nonphysicians like nurse practitioners by 206.5% from 2005 to 2021. Furthermore, payments to limited-license physicians and medical suppliers also increased by 16.3% and 44.4% respectively.
Possible Shift in U.S. Insurance Marketplace
Joshua Hirsch, vice chair of procedural services at Massachusetts General Hospital and a senior research fellow with the Neiman Institute, warns that budget neutrality policies could dramatically shift the U.S. insurance marketplace. He raised concerns over the potential patient impact of reducing physician payments to contain Medicare costs. He warns that as Medicare reimbursements continue to drop, providers may favor treating privately insured patients. It is hoped that this study will stimulate policy makers to seek solutions that benefit Medicare insured patients, who are increasingly at risk of diminished access to care. Full details of his statement can be found here.
More information
The complete analysis is available on the INQUIRY: The Journal of Health Care Organization, Provision, and Financing website. The study was conducted by the Neiman Institute, founded by the American College of Radiology in 2012. Learn more about the Neiman Institute here.
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