Washington, DC —Today, the Office-Based Facility Association (OBFA) released a new explainer video to sound the alarm over concerns about Centers for Medicare & Medicaid Services (CMS) data that shows there are 195 services under the Medicare Physician Fee Schedule (MPFS) for which Medicare reimbursement does not even match direct costs for such procedures, let alone reimburse physicians for their work they perform.
OBFA and its partners signed a letter to the leadership in both the U.S. House of Representatives and U.S. Senate requesting that Medicare Physician Fee Schedule reform include provisions to create a new site-of-service for Office-Based Interventional Care providers. Every one of the 195 services identified by OBFA are office-based interventional services and reimbursement shortfalls for these procedures are a key catalyst for independent practice closure and consolidation.
This under-reimbursement also is highly correlated to significant MPFS cuts since 2006 to cardiology, radiation oncology, vascular surgery, and interventional radiology of -18%, -21%, -28%, and -35%, respectively. A 2023 multi-specialty survey of non-hospital providers found that 53% of respondents “believe the likelihood of the practice’s success is unlikely.”
Outpatient Endovascular and Interventional Society (OEIS) Past President and OBFA board member Jerry Niedzwiecki, MD, said, “This perfect storm has created interventional and diagnostic provider deserts and patients are paying the price because they have so few options for quality care. The data from CMS underscores the need to establish a new ‘Office-Based Facility’ site-of-service to stop further closures of independent, interventional practices and provide additional resources for overall MPFS reform. Removing high-cost supplies from the MPFS – which clearly is no longer capable of properly reimbursing for such related services – needs to be a key aspect of any fundamental reform efforts to the MPFS. ”
Diagnostic Provider Deserts: https://www.obfassociation.org/interventionalanddiagnosticproviderdeserts
OEIS Survey Data: https://oeisweb.com/new-survey-data-illustrates-bleak-outlook/