The Radiology Business Management Association warned the federal government on Monday that the specialty may be reaching a “tipping point” in its ability to continue providing adequate access to care.

In comments submitted to the CMS chief, the trade group highlighted several concerns fueling its pessimistic outlook. Imaging volumes continue to climb due to an aging population, while the industry is still grappling with a shortage of radiologists to accommodate growth. This has forced physicians to work longer hours and read exams faster, spelling an “alarming increase in concerns over diminished interpretive accuracy and widespread accounts of radiologist burnout.”

RBMA noted that the latest proposed Medicare physician fee schedule, released in June, includes yet another reimbursement reduction to the specialty, despite these troubling trends.

“After 16 straight years of cuts to radiology this is an unsustainable environment in medicine,” RBMA Executive Director Bob Still wrote to CMS Administrator Chiquita Brooks-Lasure on Sept. 11. “There continue to be factors within medicine and radiology that point to a system that may be at a tipping point regarding access to care by Medicare beneficiaries.”

Still also highlighted an increasing volume of radiology procedures generated from CMS-funded therapeutics. Those include Alzheimer’s treatments lecanemab and aducanumab, which are anticipated to “enormously increase MRI volumes.” Demand for cardiac CTA as a first-line imaging exam for patients with stable angina also is increasing, as is interest in interventional procedures.

RBMA believes CMS must enact an inflation-based payment increase for physicians to help counteract these trends.

“Without such an update, there is a genuine risk of providers becoming increasingly financially strained, which could lead to a further reduction in services or diminished willingness to treat Medicare beneficiaries,” Still wrote. “This would be detrimental to the Medicare program’s goal of ensuring beneficiary access to care.”

CMS was accepting feedback on the proposed 2024 Medicare Physician Fee Schedule until Tuesday. Others submitting comments included the American Medical Association, the American Hospital Association, and the Medical Group Management Association. All three echoed similar concerns about access to care and the financial strain physicians are facing.

“This negative update would pose significant risks to patients’ access to care and health systems’ financial stability, particularly for providers serving historically marginalized communities,” the AHA wrote. “Our concern is heightened by the fact that this cut is coming in the wake of over three years of unrelenting financial pressures on the healthcare system due to COVID-19, along with rising inflation, increasing input costs, and persisting staffing shortages and supply chain disruptions.”