Carmel: Income Cuts Loom Large For Radiologists

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“Triple jeopardy” for income cuts is what radiologists in particular face following the inability of the congressional supercommittee to come to an agreement on ways to handle the federal deficit, Peter Carmel, MD, president of the American Medical Association (AMA), told attendees in a plenary speech delivered at this week’s Radiological Society of North America (RSNA) meeting in Chicago.

Carmel said the supercommittee’s failure will result in an automatic 2% reduction of Medicare, thanks to the "sequestration" formula. He noted that the cut only adds insult to injury given the 27.4% reduction triggered by the Sustainable Growth Rate (SGR) formula beginning in January and the fact that the Independent Payment Advisory Board can, if it so desires, recommend further cuts beyond SGR and sequestration should costs eclipse a spending limit.

"If that sounds like triple jeopardy, it’s because that's what it is," Carmel asserted.

While the AMA is continuing its efforts to fight the cuts, Carmel entreated radiologists and other health care professionals to mount protests of their own.

Carmel also told delegates that although the Affordable Care Act (ACA) has opened the door to providing more services to patients and eliminating health care obstacles placed in the path by insurors, “serious challenges remain”. Specifically, the ACA was not effective in repealing the SGR formula. “Because of SGR, American physicians are scheduled for a 27.4% Medicare pay cut,” Carmel said. This equates to a loss of $1 billion that would otherwise be available for the care of elderly and disabled patients in the state of Illinois alone, he pointed out.

Carmel added that Democratic and Republican lawmakers alike support initiatives to “fix” the SGR formula, and the the AMA is working to attain this goal prior to the start of Congress’ holiday recess.

"It is impossible for this country to climb out of its financial mess if we don't fix the broken Medicare system," Carmel stated. "How can we hope to improve healthcare delivery if we continue to penalize physicians and essentially drive them out of both Medicare and Tricare?"

Carmel observed that the ACA neither addressed liability issues nor eliminated the Independent Payment Advisory Board. He deemed the latter “another misguided government attempt to control healthcare costs."

On the flip side, Carmel said lobbying efforts by the AMA led to changes in the final rule on accountable care organizations (ACOs), thereby improving physicians’ opportunity to profit from quality improvements in health care delivery. Radiology-related endeavors sparked the halving of the projected reduction in imaging payments for the professional segment of imaging fees. Moreover, government proposals for a reduction for interpretation fees, which originally stood at 50%, now call for a 25% cut, and a fight to eliminate the latter continues, Carmel explained.

"When physicians stand together in a united front, we can have a profound impact," he concluded.