RBMA says federal policy is eroding patient access to healthcare
The Radiology Business Management Association is raising alarm about the combined impact of ongoing Medicare payment reductions and sweeping Medicaid changes enacted last year. RBMA warns that patient access to care, particularly in rural America, is increasingly at risk. The association pointed to its patient survey that shows increasing numbers of patients saying they are facing barriers to care.
Linda Wilgus, MBA, co-executive director of RBMA, spoke to Radiology Business at the Radiological Society of North America (RSNA) 2025 meeting. She said data collected through the Radiology Patient Action Network (RPAN), a division of RBMA's Federal Affairs Committee, shows mounting access challenges for Medicare beneficiaries as reimbursement pressures continue to ripple through the healthcare system. RPAN conducts an annual Medicare beneficiary survey sent to patients age 65 and older, tracking access issues over time.
“Our trending has shown that year over year, patients are starting to have an access-to-care issue. They're having to drive further for care. Rural facilities are closing. It's taking longer to get an appointment and they are actually having difficulty finding physicians that accept Medicare,” Wilgus explained.
One recurring survey question asks beneficiaries whether they view cuts to physician reimbursement as cuts to Medicare itself. Wilgus said the response has been consistent.
“Overwhelmingly, 85% of the Medicare beneficiaries say they do,” she said. “So, our legislators report to their constituents that they're not going to cut Medicare, but actually their constituents see a cut to their payment to their physicians is in fact a cut to Medicare.”
Leveraging patient comments to influence congressional policy
RBMA uses the survey findings as a cornerstone of its advocacy strategy in Washington, D.C., Wilgus said.
“We use this data when we write comment letters to CMS. When we go on the Hill, we have actually taken the physical survey results and have left them with congressional representatives in order to show them the impact some of these cuts have had on their constituents directly. We write op-eds and we put them in Axios, CNN, and even local newspapers where we're targeting a particular congressman that has influence in this area,” Wilgus said.
She warned that access challenges often result in patients delaying or avoiding care altogether, which can worsen outcomes and drive up costs.
“Our Medicare beneficiaries are finding that their doctors are no longer providing services in rural America and they're having to drive to urban areas or suburban areas to get care, and sometimes they just won't do it,” she said. “So that just means that they're going to present at a hospital with more acute illnesses, and they're not taking care of their chronic illnesses.”
Medicaid cuts will have a major impact on rural hospitals
Those pressures are expected to intensify following passage of the One Big Beautiful Bill Act, which includes more than $1 trillion in Medicaid reductions over the next decade. She noted that the Congressional Budget Office estimates 11.8 million people will lose health insurance coverage due to the changes, with rural health systems bearing the brunt of the impact.
“I read a statistic that they're estimating 300 rural hospitals to close because of this bill,” Wilgus said. “So imagine, if you're battling cancer, your wife is expecting, and you've got to now drive not 30 minutes, not 40 minutes, but you've got to drive two hours to get your care.”
RBMA has issued guidance to its members to help them prepare, including strengthening the eligibility verification processes and engaging commercial payers, where reimbursement conditions allow.
Wilgus said the one positive provision in the One Big Beautiful Bill Act was a one-time 2.5% increase for the Medicare payment conversion factor in 2026. But she said there were high hopes for more permanent fixes.
“My advice to members is your associations matter. Your associations, the ACR, RBMA, ASRT, we're out there fighting for you,” she said.
She encouraged radiology practices to engage directly with lawmakers and demonstrate their role as both care providers and employers in their communities.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]