Posted on May 13, 2020 in General
Medicare for All, in one form or another, is being seriously considered by many people as a viable setup for the United States’ healthcare system. Shifting to such a setup would undoubtedly cause substantial change throughout the industry, affecting everyone — and radiologists would certainly be included.
While there’s still great uncertainty about what a Medicare for all future would bring, here are a few ways that it might impact radiology in the U.S.
Any proposed change to healthcare must first consider potential effects on patient care, and that brings up the issue of access. Specifically, there are concerns that a Medicare for all system would result in fewer people becoming physicians in general and radiologists in particular.
This concern stems from the rising cost of education and the potential decreased payments that radiologists would receive for their services (see reimbursements below). As undergraduate and medical school costs escalate, the potential income simply isn’t worth taking on the financial burden and risk of such substantial student loans.
Already, some radiologists voice feeling “trapped” by their student loans and no longer believe they’re in the rich class of America. This could lead to a natural decrease in people entering the field, and an income reduction brought on by Medicare for all would only exacerbate the problem.
Reviewing the healthcare system at large, the Congressional Budget Office has acknowledged this issue. It also, however, has noted that the government “could implement policies to increase the supply of providers.” Thus, an increased need for radiologists is an issue that needs to be addressed, but it’s one that could be potentially resolved.
Another concern about patient care is that a Medicare for all system would disincentivize patients to care for themselves. With health expenses largely paid for, patients may have less need to eat healthily, exercise regularly, and otherwise live a generally healthy lifestyle.
Again, however, this is a potential downside that could be addressed via creative programs. Already, there are workplace and insurer-sponsored programs that reward patients for taking healthy actions.
This concern isn’t too specific to radiology only, but it’s one that everyone in the healthcare industry should be aware of.
While the healthcare field is already rife with malpractice risks, there’s some fear that a Medicare for all system would lead to an increase in malpractice suits. In turn, this could lead to an increase in defensive medicine.
An increase in defensive medicine, where providers overuse diagnostic tests, not for better patient care but to better protect their own liability, generally isn’t a good thing. Concerning radiology, however, it brings two interesting considerations.
On one hand, radiology providers won’t be immune to an increase in potential malpractice suits. Just as other providers are overly cautious, radiologists may follow suit and perform more tests than are necessary. Of course, this can come with some long-term considerations for patients who receive excess tests (which could lead to other malpractice suits).
On the other hand, radiologists may see a spike in work as physicians order more diagnostic services. Such a large part of radiology is diagnostic that this could lead to a lot more work for providers in the field. This wouldn’t automatically lead to greater income, though (see below).
Of course, one of the biggest concerns providers have over Medicare for all is that reimbursement rates will change. Many fear that their reimbursement rates will decrease which is a legitimate concern and could lead to substantially lower revenue for providers. Some might actually see their per-service reimbursements go up, though.
Most private insurers have much higher reimbursement rates than what Medicare offers right now, and it’s unlikely that any Medicare for All system would match the current private insurer rates. There might be a slight increase in Medicare-based reimbursements, however.
Thus, this type of change would largely result in an equalization across radiology providers. Those who primarily service patients with private insurers would probably see their revenue and income drop, while those who already serve mostly publicly insured patients might experience a slight increase.
The other major change would, naturally, be how patients are billed. Providers would no longer bill each patient individually based on the patient’s insurance coverage and the provider’s contract with that insurer. Instead, a true single-payer system would have every patient’s bill sent through the same one-payer administration.
For radiology providers, the simplicity of a one payer system not only makes billing more efficient but also eases bill-collection issues. With such a system, radiology providers wouldn’t need to worry as much about whether they’re in-network, how to collect copays, or if a patient has met their plan’s high deductible. Collections would be much more secure because every patient’s financial responsibility would be better known and reduced under this type of setup.
As the push for Medicare for all systems grows, the future of the entire healthcare system is more and more uncertain.
At Dexios, we remain committed to providing the highest level of billing services for radiology providers both now and in the future. We offer extensive billing solutions for radiologists, and our expertise and experience make us well-poised to adapt as the healthcare system evolves in the future.