by
John R. Fischer, Senior Reporter | November 22, 2021
From the November 2021 issue of HealthCare Business News magazine
Faced with potential reimbursement cuts
Working in one of the most profitable departments in hospitals, radiologists often face pressure to meet target volumes and reduce lengths of stay for patients to bring in more revenue. This pressure is expected to increase over the next year due to a new rule in the 2022 Medicare Physician Fee Schedule. Under the new rule, wages will increase for clinical labor staff. Because the schedule is budget-neutral, payments for medical supplies and equipment costs will decrease, according to Dr. Gregory Nicola, chair of the commission on economics for the American College of Radiology.
When adjusted for the conversion factor in calculating reimbursement, mandated sequestration and cuts to practice expense values, updating the labor wages is estimated to levy a 5% cut to interventional radiology and 1% cut to diagnostic radiology, after adjustments made by CMS. While more severe for interventional radiology, cuts to diagnostic radiology are further compounded by Medicare cuts made the year before that were originally supposed to be 10%-11% but later downgraded to a 4% cut. The remaining portion of the original cut, however, is set to go into effect as part of the upcoming 2022 schedule, according to Coffta.
This could make it harder to recruit staff for weekend and off-hour shifts and for radiologists to maintain their offices or upgrade equipment. “We are wary of buying technology when our payment structure isn’t stable,” says Nicola. “We’re wary of hiring staff to help us cover difficult shifts or subspecialty care that we may have a need for but don’t want to hire because the money is tight.”
While Nicolas agrees that clinical labor staff wages should be increased, he says that the timing is off due to the pandemic and that the money should not come at the cost of reducing reimbursement for radiologists and other specialists.
Bob Still, executive director for the Radiology Business Management Association, says the formulas used to form the Medicare Physician Fee Schedule rely on survey factors that may not be accurate, as the sample is too small. “When Medicare does new surveying on these practice expense areas and clinical labor cost, they need to do it in a way that is inclusive, fair and statistically valid.”
How to push back
Radiologists today are living in a time of disruption, fueled by advances in technology, an ongoing global health crisis and changes in payment models; and the profession must do whatever it can to stay at the forefront of these transitions. “We have to embrace change and look for opportunities to practice differently,” says Nicola. “That will allow us to be innovative and not disruptive. I just encourage our community to do that.”
