Neurologists are fighting a decision by the Centers for Medicare & Medicaid Services to pay less, starting next year, for diagnostic tests used to assess muscle and nerve pain or weakness. The change comes under a provision of the Affordable Care Act aimed at cutting Medicare costs. It will also help to redirect money to primary care physicians, who are widely seen as underpaid and are being asked to take on more responsibilities under the federal law.
Neurologists say the change could injure patient access to care. But this is likely an early example of what could become a common debate:
The tests effectively subsidize other kinds of neurology care that provide less lucrative payments, and specialists said the change could prompt some neurologists and hospitals to see fewer Medicare patients.
But Jonathan Gruber, an MIT economist who was a consultant to the Obama administration during drafting of the Affordable Care Act, said there is little doubt that more money must be directed to primary care services.
“We have a system that everyone agrees is out of whack,” Gruber said. “Everyone agrees we spend too much on health care. The problem is, once we get to fixing it, that’s where the disagreements arise.”