Diagnostic Care Is Under Siege – and Only Congress Can Save It

As the United States continues to combat the COVID-19 pandemic, another, more subtle health crisis lurks in the wings: the consequences of delayed or interrupted care.

According to recent data published by the Centers for Disease Control and Prevention, an estimated 40 percent of adults have avoided seeking medical care due to pandemic-related fears. In the area of medical imaging and diagnostics, these dangerous trends are even more acute. A JAMA study published last year showed that new diagnoses of breast cancer dropped by a staggering 50 percent in 2020 – a harrowing statistic that led the National Cancer Institute to foreshadow a potential spike in deadly undetected cancers during the months ahead.

With COVID-19 pummeling health care systems across the country, we can only expect more Americans to continue avoiding critical diagnostic care. Given this dire reality, strong leadership in Washington will be more important now than ever before. Lawmakers must begin working in a bipartisan way to decisively adopt policies that support improved public health outcomes and the safe delivery of timely and medically necessary imaging and diagnostic care for American patients.

On this front, the most pressing order of business should be reversing counterproductive Medicare reimbursement policies that threaten to undermine the nation’s health care system amid the ongoing COVID-19 public health emergency. Fortunately, Congress recently made some progress in mitigating the specialty provider payment cuts included in Medicare’s Physician Fee Schedule Final Rule for 2021. Implemented despite fervent opposition from dozens of bipartisan lawmakers and a large coalition of health care stakeholder groups including the Medical Imaging & Technology Alliance, the American Medical Association and the American Hospital Association , the PFS Final Rule imposed deep Medicare reimbursement reductions to a slew of specialty provider services, including radiology.

Recognizing the devastating impact of these policies on providers, including radiology practices that were already grappling with an unprecedented drop in patient volume and revenue, Congress moved to phase-in and partially mitigate these Medicare payment cuts – in some cases by more than half of the originally slated reimbursement reduction– in late December 2020.

Despite this progress, more must be done to ensure the ongoing viability of diagnostic imaging providers serving America’s vulnerable patient populations.

Under the current Medicare Hospital Outpatient Prospective Payment System, cutting-edge, precision diagnostics and nuclear radiopharmaceuticals are under-reimbursed. As a result, physicians are discouraged from utilizing advanced diagnostic imaging agents, undermining patient access to innovative solutions that can better detect dangerous conditions such as prostate cancer, Alzheimer’s and Parkinson’s disease. Many lawmakers recognized the harm of this policy during the 116th Congress and introduced a legislative remedy to ensure imaging drugs are appropriately reimbursed. This legislation must be reintroduced and addressed promptly in the 117th Congress.

Beyond fixing harmful payment policies, supporting patient care also means ensuring medical devices and equipment are properly serviced, maintained and secured. Tampering or altering a medical device, intentionally or unintentionally, can impact its performance and put patients at risk – especially in the context of a deadly pandemic. That’s why all medical device servicers must be properly trained and held to the same standard of repair – as well as the same standard of accountability by the Food and Drug Administration and other regulatory bodies.

Unfortunately, in August of last year, a group of lawmakers introduced legislation that would further undermine the mechanisms that hold medical device servicers accountable, and which original equipment manufacturers strongly oppose. This year, it will be imperative for Congress to take a more nuanced, patient-oriented approach that ensures any medical device servicing job is conducted in a way that prioritizes patient safety and maximizes device efficacy. Any alternative approach would not be in the best interests of patients and the providers who serve them.

The new Congress faces a plethora of difficult challenges and the problems outlined above only scratch the surface. But we are optimistic that our lawmakers, including those most recently elected, will rise to the moment and fight to enact policies that protect patients, support beleaguered providers and ensure the survival of America’s medical imaging and diagnostics sector as we finally turn the corner on the greatest public health crisis of the last century.

Michael Wendt is the senior vice president of customer services, Siemens Healthineers, and chairman of the Medical Imaging and Technology Alliance Board of Directors.

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