The Medicare Payment Advisory Commission (MedPAC) mid-year report to Congress, released June 14, 2019, did not contain specific recommendations directed at imaging, but radiology would be impacted by some concepts discussed in the report, if implemented by the Centers for Medicare and Medicaid Services (CMS).
The independent advisory commission, which guides Congress on Medicare issues and policy development, dedicated portions of its June report to the possibility of site-neutral payment policies, measuring quality of care in Medicare and evaluating compensation disparities between primary care and specialty physicians, which impact the entire house of medicine, including radiology.
In Chapter 4, titled “Mandated Report on Clinician Payment in Medicare,” the commission makes its most direct references to imaging services, although no formal recommendations are made to Congress. It concludes, “Access for Medicare beneficiaries continues to be relatively stable and as good as or slightly better than access for individuals with private insurance. Volume growth varied by type of service, and some services have significantly shifted across settings, affecting both volume and spending for clinician services.”
Imaging services, specifically CT, are discussed as one of three examples of services that have experienced a shift in site of service to the generally more expensive hospital outpatient setting, resulting in increased costs to Medicare. MedPAC mentions site-neutral payments as a potential solution to this issue, but again, no formal recommendation is made.
The commission also references a chapter from the June 2018 report regarding lowering payments for specialty services including, but not limited to, imaging, in order to increase payments for primary care physicians.
Other topics discussed in the report include beneficiary enrollment, drug pricing, assessing the Medicare Shared Savings Program’s effect on Medicare spending, Medicare Advantage encounter data, the Medicare Advantage quality bonus program, payment issues in post-acute care and options for slowing the growth of Medicare spending for emergency department services.
The June 2019 MedPAC Report to Congress is available online.