Along with clinical decision support, another concept that is included in the sustainable growth rate (SGR) drafts coming out of Congress is “dampening.”
Radiology has been hit with 13 cuts in reimbursement since 2006. In most cases, there was no time to strategize and adjust our practice staffing and finances. At its core, dampening legislation would prevent the Centers for Medicare and Medicaid Services from reducing rates for any specific procedure by more than a given amount in a single year.
The original American College of Radiology (ACR) proposal was to limit reductions to 12.5 percent per year. ACR legislation would also require the U.S. Department of Health and Human Services Secretary to disclose any data, analysis and justification if there is more than a 12.5 percent drop or overall reduction of more than $50 million.
This policy would apply across all of medicine, not just radiology. Other specialties have expressed support for the concept.
Currently, the draft proposals for SGR repeal phase in any 20 percent or more RVU cut over two years. While less than what we had hoped, it is recognition that there is significant and unfair impact when onerous reductions are implemented all at once.
ACR is vigorously fighting against any reductions. However, we need to remain part of the conversation as health care changes. Dampening is one way to moderate the impact as we transition from fee-for-service toward alternative payment models.
An independent bill with dampening language is also being prepared in the event the SGR proposal does not survive the legislative debate.
More to come …
Author – Howard B. Fleishon, M.D., MMM, FACR