Collapse of Supercommittee A Mixed Bag for Radiology

The failure of the Congressional supercommittee to reach a compromise on spending cuts has positive and negative implications for the radiology sector and the health care community in general. On the one hand, the group’s inability to reach a consensus brings an automatic 2% cut to most Medicare spending. This adds up to $123 billion over the next decade, according to a Congressional Budget Office report from September—a far more palatable reduction than the $500 billion in cuts to Medicare and Medicaid that were proposed as a bargain by Democrats in October. While radiology cuts were indeed in play in the supercommittee’s negotiations, the fact that the group could not produce a specific set of budget-cutting recommendations, including cuts to radiology, is “helpful," says Cindy Moran, assistant executive director of government relations and health policy at the American College of Radiology (ACR). However, she observes, the supercommittee also failed to produce any fundamental reform of entitlement programs that may have solved such ongoing problems as the Sustainable Growth Rate (SGR) provision, which each year brings with it threats to slash physician payments. “I had hoped the supercommittee would have dealt with fundamental reform, and that was probably an unrealistic goal from the beginning,” Moran says. Moran adds that the next few weeks will prove critical as Congress deals with another “SGR fix” bill. To offset the cost of the fix for one or two years, Congress will seek to identify other cuts it can make to health care spending. This may mean an even greater threat for radiology than when all types of spending are on the table, as they were with the supercommittee. “When you are in a smaller pool, the risk is often greater,” Moran observes. To fight back, the ACR’s government relations team will be “playing both offense and defense,” she says. It will “go on the offensive” concerning proposals to increase the equipment utilization rate and to require pre-authorization for imaging. Going on the defense will entail adding language to other legislative vehicles—for example, the SGR bill—to avoid a multiple procedure payment reduction. “The main point is that now that the supercommittee is dead, all eyes are going to focus on what is the next or last legislative vehicle to leave the station,” Moran observes. She adds that progress on this front may be faster than usual because committees with jurisdiction over health care spending issues have been anticipating the possible failure of the supercommittee and have started working ahead on issues. So for those who may be pleased with the supercommittee’s demise, Moran has a few words of advice: “Hold off on the eggnog, because there is lots of mischief that can happen between now and the end of the year.”