JNIS?: cuts in Medicare payments jeopardize patient access to care

FAIRFAX, Va.– The final 2021 Medicare Physician Fee Schedule (MPFS) issued this week by the Centers for Medicare Medicaid Services (CMS) will result in reimbursement cuts in the range of 10% for neurointerventional procedures, according to a detailed analysis published last week in the Journal of NeuroInterventional Surgery™, the leading international peer-reviewed journal for the clinical field of neurointerventional surgery. Practitioners warn that this measure will jeopardize access to lifesaving care for individuals experiencing strokes, aneurysms and other deadly conditions.

The JNIS article outlines the potential impact of the new fee schedule and raises the alarm that this action by CMS could further compound current challenges to the viability of neurointerventional practices, which already have been severely impacted by the COVID-19 pandemic.

The catalyst for this potentially devastating change is Medicare’s budget-neutrality requirements, which require substantial reductions to offset payment increases approved in other areas of the health care system. The authors of the JNIS analysis point to the fact that these impacts will almost certainly be compounded in upcoming years. JNIS Editor-in-Chief Felipe Albuquerque, MD, says the article authors predict even more severe economic impacts as private payers follow Medicare’s lead.

“This rule originates in Medicare, but we know that private insurers often base their own rates on those set by CMS. Together, that represents about 80% of the patient population,” says Albuquerque. “Some practices will not be able to withstand that level of reimbursement reduction for very long.”

To combat this draconian change, the Society of NeuroInterventional Surgery (SNIS)–an association representing neuroendovascular care professionals and the sponsor of JNIS–has joined a coalition of professional societies urging Congress to provide a legislative fix.

“We’ve been working for more than two decades to increase access to neurointerventional therapies that actively save lives,” says co-author Joshua A. Hirsch, MD, FSNIS, chair of the SNIS health policy committee, “but the thoughtlessness of CMS’ approach put practices at risk in the midst of fighting a pandemic. It is inexcusable. Congress needs to move quickly and add stability to the system without diminishing access to critical diagnostic tests and surgical procedures.”


About the Journal of Neurointerventional Surgery™

The Journal of NeuroInterventional Surgery™ (JNIS) is the leading peer-reviewed journal for scientific research and literature pertaining to the field of neurointerventional surgery. The journal was launched in 2009 following growing professional interest in neurointerventional techniques for the treatment of a range of neurological and vascular problems including stroke, aneurysms, brain tumors and spinal disorders. JNIS is published by BMJ on behalf of SNIS and is also the official journal of ESMINT: The European Society of Minimally Invasive Neurological Therapy, the Interventional Chapter of the Australian and New Zealand Society of Neuroradiology (ANZSNR), CING, the Hong Kong Society of Interventional Therapeutic NeuroRadiology (HKSITN), the INR Chapter of NRST, and the Society of Therapeutic Neurointervention (STNI).