This post is authored by Stephen R. Ramee, MD, FACC, chair-elect of the Interventional Scientific Council.
The 2013 Medicare Physician Fee Schedule continues the Centers for Medicare and Medicaid Services' (CMS) campaign to reduce payments for complex procedures and diagnostic tests in order to redirect resources to other services. An agenda that began with crippling cuts to echocardiography and SPECT and continued with implementation of faulty practice expense data that cut cardiology services across the board has now targeted EP procedures and PCI. Although the cuts result in large measure from decreases in the amount of time needed to perform the typical EP study and ablation or PCI (note that the system for determining RVUs is heavily driven by procedure time), CMS payment policy decisions have made things worse. By unilaterally rejecting recommendations from the physician community that would provide opportunities for cardiologists to accurately report more complex procedures, CMS is preventing physicians who care for the most challenging patients from being fairly compensated. ACC will be vigorously opposing CMS’s decisions and working with the Society for Cardiovascular Angiography and Interventions (SCAI) and the Heart Rhythm Society (HRS) to rectify these decisions. Unfortunately, no changes to the fee schedule can happen before 2014.
Our practices that have already experienced precipitous cuts in payment for core services now face payment reductions on the order of 27 percent for EP studies/ablations and 20 percent for PCI. Many of us, myself included, are astonished that the reward for a relentless focus on quality that has brought about a 27-percent reduction in mortality from heart disease is a payment cut.
While the cardiovascular field is justifiably angry about the latest round of payment cuts, it’s important to recognize that this is the byproduct of a broken system for physician payment. Congress’s inability to fix the Sustainable Growth Rate (SGR) has meant a decline in real terms in the resources our nation devotes to paying for the physician services Medicare patients need and deserve. Rest assured that ACC will be doing everything possible to reverse CMS’s bad decisions and to stop the SGR cut from going into effect. But we will also be redoubling our efforts to make sure policymakers understand the value of the lifesaving work cardiologists do every day and to move toward a payment system that supports and rewards our specialty’s dedication to improving care and outcomes for patients with heart disease.
For full coverage of the 2013 fee schedule and coding changes, visit CardioSource.org/PhysicianPayment. Stay tuned to The ACC Advocate for updates on ACC’s action. Be sure to follow @Cardiology on Twitter for the latest advocacy and health policy news.