Obama Win Could Impact Radiology in Lame Duck Session
Mitt Romney’s concession speech call to put politics aside and move forward could be just what radiology ordered, but will it be heeded. With the House under Republican control and the Senate retaining a slim Democratic majority, legislators will have to “reach across the aisle” to get things done by the end of the year, as Romney counseled. And there is indeed much to do. Along with reversing the 2013 automatic spending cuts that were created when the Deficit Reduction Act's “supercommittee” failed to come to agreement on selective cuts, there is the very important SGR-fix to pass. Without the so-called "doc fix," reimbursement for physicians who see Medicare patients will be slashed automatically by nearly a third. Before the election, Joshua Cooper, director of government relations for the ACR, told ImagingBiz that a decisive victory for either side would be better than a close tie because it would tap down some of the bitterness of the campaign that could make the legislators come back for the lame-duck session of Congress “just hating each other” and determined to do the bare minimum they had to do and then get out of town. In that scenario, they might pass just a temporary two- or three-month SGR fix without any added provisions – “clean” in Washington language – like the very important Senate and House bills to block the Multiple Procedure Payment Reductions (MPPR) until a study can be done on whether the savings CMS believes are there actually are real. However, with the popular vote, if not the electoral vote, close to tied, the mood may remain deeply partisan no matter what Romney or President Obama said in their respective end-of-election speeches. The other factor is that the election of Obama makes the future of the Affordable Care Act (ACA) more certain. Romney had, of course, vowed to repeal parts of it and Obama stood behind “Obamacare.” The ACA will expand the number of insured greatly, but it is not no-strings-attached. The ACA also pushes research on outcomes, transparency on quality and costs, and use of Affordable Care Organizations (ACOs) that seek to lower health care costs. To the extent that diagnostic imaging business models that rely on volume and high reimbursement levels conflict with appropriate use and efficiency, there could be pain for radiology in adjusting to a new health care landscape. In addition, the ACA device tax may impact decisions on upgrading aging imaging equipment. Meanwhile, the possibility of higher taxes on top earners could also hit radiologists' personal income at the exact same time as their reimbursement shrinks. Frank Lexa, M.D., broke down these issues in the last issue of the Journal of the American College of Radiology. Click here to see why he predicts that the 2012 election will have an impact on radiology for years to come. Meanwhile there is one final factor that will not come to be because of the re-election of President Obama. There will be no radiologist in the first family. Mitt Romney's son Ben would likely have taken his board exam in radiology during his father's time int he White House, if the election had favored the GOP. Last summer, Curtis Kauffman-Pickelle mused on what that might have looked like.