A game-changer for radiology? Exploring the economics behind the 2017 MPPR reduction

When Congress passed a $1.1 trillion Omnibus Spending Bill in December 2015, it included a rollback of the professional component (PC) Multiple Procedure Payment Reduction (MPPR) from 25 percent to 5 percent. The reduction was applauded at the time by organizations such as the American College of Radiology (ACR) and has now been in effect since January 2017.

So what kind of impact is this policy shift having on radiologists in the U.S.? A team of researchers analyzed claims data from 2012 to 2014 to look into that very question, publishing findings in the Journal of the American College of Radiology.

“Prior work in a variety of settings has shown that Medicare and Medicaid payment cuts can adversely affect patient access, quality of care, and mortality,” wrote lead author Gelareh Sadigh, MD, department of radiology and imaging sciences at Emory University School of Medicine in Atlanta, and colleagues. “In those settings, many hospitals cut services, such as operating costs and personnel, as a result of ongoing financial pressures. Similarly, many physicians have indicated a decreased likelihood of accepting new Medicare patients. Regarding MPPR, stakeholders expressed concerns to CMS that these payment cuts could adversely affect Medicare beneficiaries’ access to high-quality imaging care.”

Overall, the authors found that the average annual dollar amount per radiologist payment reduction from the individual component of MPPR was more than $2,500 in 2012, more than $2,600 in 2013 and more than $2,800 in 2014. Radiologists lost an average of $13-14 per MPPR-affected service in that timeframe.

Based on those statistics, and the fact that the MPPR reduction impacts more than 27,000 radiologists each year, Sadigh and colleagues projected that the policy change will lead to an increase in radiologist professional payments of more than $50 million annually.

The authors give credit to the MPPR reduction to advocacy groups such as the ACR, which fought for this change to take place.

“Although a variety of political, legislative, and regulatory changes were all affecting health care payment system changes simultaneously, we believe that the ACR’s activities were extremely influential in bringing about the MPPR rollback,” the authors wrote. “As a result of these advocacy efforts, we estimate that CMS professional payments to radiologists will increase well more than $50 million each year beginning in 2017.”