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(HealthNewsDigest.com) – Truth may be a casualty in the red-hot health care fight. But even the most vociferous opponents can agree that the smoke is overshadowing a looming health care crisis that Congress can and should address immediately.
Next month, sharp cuts in the government’s reimbursement rates for certain cardiology services proposed by Medicare will be finalized. If implemented in their current form, the Medicare regulations will threaten to put accessible and quality cardiac care out of reach for millions of Americans, hitting those in rural areas hardest.
At issue is the amount Medicare, a federal program that helps people 65 or older pay health care costs, reimburses cardiologists for lifesaving diagnostic testing. Beginning in January 2010, reimbursement rates could be slashed in some cases by 40 percent for imaging and other vital diagnostic tools cardiologists use daily to save lives.
This means many cardiologists, especially those in rural areas, will have to stop providing these tools in their offices and instead send their patients elsewhere to get these tests. Many rural patients will face long distance travel to hospitals (three to four-hour round trips have been documented) and out-of-pocket costs that are as much as five times higher than in-office co-pays. This could also create lengthy and potentially dangerous wait times for tests and test results that will take days, not hours as currently is the case when they are obtained in the cardiologist’s office.
This isn’t worst case scenario bluster—it is already happening. As one Little Rock cardiologist noted, “Over the past seven years we have cut outreach clinics from 21 locations down to eight because of the payer mix – Medicare and Medicaid reimbursements do not cover our cost to provide services.” A Fort Collins heart specialist said “If these cuts go through we will be forced to close all but three of our 15 rural clinics. Most of those patients no longer will have easy access to tests like echocardiograms and they might not be willing or have the time to travel the great distances to get those lifesaving tests done.”
Without question, additional drastic cuts will force other cardiologists to close their outreach offices completely since many of these operations run at a fiscal loss but offer an important service to remote communities. The Fort Collins group indicated “We had a total of 22,000 visits last year in our rural areas but sustained losses of close to one million dollars in two years in providing these services.”
Medicare is in this situation because of poor information used to calculate the reductions. The proposed cuts are based on a survey that used data from only 53 cardiologists—the equivalent of only one quarter of 1 percent of the nation’s cardiologists.
The shame is that this comes as America’s cardiologists are making great strides in the fight against cardiovascular disease—the nation’s leading killer. Not so long ago, a heart disease diagnosis was a virtual death sentence. But thanks to the ingenuity and determination fostered under our system, advances in technology and care have reduced heart-related deaths and the severity of heart-related illnesses by more than 26 percent.
We can keep this momentum going if Congress intervenes to prevent these severe cuts from going through. To make sure Congress understands what is at stake, 23,000 cardiologists have united to form the Guarding Hearts Alliance.
Cardiologists remain committed to doing our part to control costs while providing Americans with the best care possible. We support physician credentialing, quality accreditation of imaging facilities and the use of appropriateness criteria to ensure that patients receive the right test at the right time. When it comes to health care reform, we have only one condition: any changes must put the patient first.
Unfortunately, the proposed changes in Medicare will put lives at risk in an attempt to save money—an attempt that ironically will cost the system and Medicare beneficiaries more. We have come so far in our battle against the United States’ Number One killer and we cannot afford to turn back the clock. We hope Medicare and Congress take the opportunity to make a difference in protecting heart health for all Americans.
Phillips, an M.D., F.A.C.C., F.A.C.P., is president of Austin Heart, and the national president of the Guarding Hearts Alliance.
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