The CardioVascular Coalition (CVC), a coalition of physicians, care providers, advocates, and manufacturers working to improve awareness and prevention of peripheral arterial disease (PAD), has called on Congress and the Centers for Medicare & Medicaid Services (CMS) to address severe proposed cuts to specialty provider services in order to help increase access to care.
CMS recently proposed cutting payments for revascularisation services by approximately 23% in the proposed Physician Fee Schedule (PFS) Rule for CY2022. The proposed cuts, which are being driven by a provision that purports to update clinical labour data, would have a severe impact on cardiology, vascular surgery, venous, radiation oncology, and radiology practices. Though outpatient health services—including revascularisation—are cost-effective and convenient for patients, the proposed cuts would have profoundly negative effects on patient access and health equity. If the proposed cuts are finalised as currently proposed, Medicare beneficiaries will face more serious risks of limb loss.
“As we recognise PAD Awareness Month and the major impact that PAD has on Americans—particularly people of colour—I am deeply troubled by CMS’ flawed proposal to cut vital services like revascularisation by as much as 23%,” said CVC Board member Jeff Carr (Tyler Cardiac and Endovascular Center, Tyler, USA) . “At a time when America is suffering a PAD and amputation crisis on top of the COVID-19 pandemic, it is absolutely critical to ensure patients’ continued access to the services that are proven to help prevent amputations and slow disease progression. Unless Congress and CMS act to address these proposed cuts, I fear that it will be harder for patients to access necessary care, resulting in even more amputations, worse outcomes, and even greater healthcare disparities.”
According to estimates, PAD affects nearly 20 million Americans and is responsible for 80% of the 200,000 non-traumatic limb amputations that take place in the USA each year. These non-traumatic amputations often occur without any diagnostic testing, meaning PAD patients are losing limbs before they receive testing to determine if limb-saving interventions are an option.
PAD is exacerbated by conditions like diabetes, chronic hypertension, and renal disease, which are most prevalent in minority populations. Access to revascularisation therapies is especially vital to the African American, Hispanic, and Native American populations who are two to four times more likely to undergo a limb amputation due to PAD because of the increased prevalence of diabetes, obesity, and other risk factors.
“To address the issues of patient access and systemic health inequity in our country, CMS must reverse course and not finalise the clinical labour policy in the 2022 PFS Proposed Rule,” continued Carr. “Further, CMS should work closely with Congress to fundamentally reform the Physician Fee Schedule so that any future unjustified cuts to specialty provider services can be avoided.”
To learn more about PAD and PAD Awareness Month, click here.