Mary Ellen Schneider

Enacting comprehensive state laws that ban smoking in workplaces and restaurants as well as raising the cigarette tax by $1 per pack across the country could bring in billions in revenue for cash-strapped states, while also saving nearly 2 million lives, according to new estimates from the American Cancer Society Cancer Action Network.

The ACS CAN released two reports on June 15 that examined the public health benefits and economic savings from strengthening state antitobacco policies. In one report, researchers from the University of Illinois at Chicago looked at what would happen if the 27 states without comprehensive smoke-free laws were to enact such laws. In the second report, the same researchers considered the impact if all 50 states and the District of Columbia were to adopt a $1 per pack increase in the cigarette excise tax.

Photo credit: ©bilderbox/fotolia.com

"The bottom line is that strong tobacco control policies are a win-win for state legislators, for the states themselves, and [for] their constituents," said John R. Seffrin, Ph.D., chief executive officer of ACS CAN.

Currently, 23 states and the District of Columbia have enacted comprehensive laws that ban smoking in all bars, restaurants, and workplaces. The remaining 27 states have either less-comprehensive laws or no laws at all in this area. But when the researchers considered the impact if these 27 states were to adopt comprehensive smoking bans, they found that more than 1 million adults would quit smoking, nearly 400,000 children would never start smoking, and smoking-related deaths would fall by 624,000.

On the economic side, those 27 states would see a savings of about $316 million from lung cancer treatment, $875 million from heart attack and stroke treatment, and $128 million from smoking-related pregnancy treatment. And the researchers estimated that Medicaid programs in those 27 states would save a collective $42 million.

The report on tobacco taxes found similar public health and financial gains if a $1 per pack tax increase were enacted around the country. Such a tax would result in 1.4 million adults quitting smoking, 1.69 million children never starting to smoke, and 1.32 million fewer people dying from smoking-related causes. States also could benefit from both decreases in Medicaid spending and increased revenue. The report estimated that the tax would cut Medicaid spending by about $146 million across the states, and would bring in $8.62 billion in new state revenue.

Dr. Seffrin said that the results are attainable. An increasing number of states are adopting smoke-free laws and nearly all the states have increased cigarette excise taxes in recent years.

But he noted the ACS CAN is concerned that the tobacco industry is working to erode current tobacco-control laws at the state level. For example, there have been efforts in several states to add exemptions to the smoke-free laws.

Enacting comprehensive state laws that ban smoking in workplaces and restaurants as well as raising the cigarette tax by $1 per pack across the country could bring in billions in revenue for cash-strapped states, while also saving nearly 2 million lives, according to new estimates from the American Cancer Society Cancer Action Network.

The ACS CAN released two reports on June 15 that examined the public health benefits and economic savings from strengthening state antitobacco policies. In one report, researchers from the University of Illinois at Chicago looked at what would happen if the 27 states without comprehensive smoke-free laws were to enact such laws. In the second report, the same researchers considered the impact if all 50 states and the District of Columbia were to adopt a $1 per pack increase in the cigarette excise tax.

Photo credit: ©bilderbox/fotolia.com

"The bottom line is that strong tobacco control policies are a win-win for state legislators, for the states themselves, and [for] their constituents," said John R. Seffrin, Ph.D., chief executive officer of ACS CAN.

Currently, 23 states and the District of Columbia have enacted comprehensive laws that ban smoking in all bars, restaurants, and workplaces. The remaining 27 states have either less-comprehensive laws or no laws at all in this area. But when the researchers considered the impact if these 27 states were to adopt comprehensive smoking bans, they found that more than 1 million adults would quit smoking, nearly 400,000 children would never start smoking, and smoking-related deaths would fall by 624,000.

On the economic side, those 27 states would see a savings of about $316 million from lung cancer treatment, $875 million from heart attack and stroke treatment, and $128 million from smoking-related pregnancy treatment. And the researchers estimated that Medicaid programs in those 27 states would save a collective $42 million.

The report on tobacco taxes found similar public health and financial gains if a $1 per pack tax increase were enacted around the country. Such a tax would result in 1.4 million adults quitting smoking, 1.69 million children never starting to smoke, and 1.32 million fewer people dying from smoking-related causes. States also could benefit from both decreases in Medicaid spending and increased revenue. The report estimated that the tax would cut Medicaid spending by about $146 million across the states, and would bring in $8.62 billion in new state revenue.

Dr. Seffrin said that the results are attainable. An increasing number of states are adopting smoke-free laws and nearly all the states have increased cigarette excise taxes in recent years.

But he noted the ACS CAN is concerned that the tobacco industry is working to erode current tobacco-control laws at the state level. For example, there have been efforts in several states to add exemptions to the smoke-free laws.

Enacting comprehensive state laws that ban smoking in workplaces and restaurants as well as raising the cigarette tax by $1 per pack across the country could bring in billions in revenue for cash-strapped states, while also saving nearly 2 million lives, according to new estimates from the American Cancer Society Cancer Action Network.

The ACS CAN released two reports on June 15 that examined the public health benefits and economic savings from strengthening state antitobacco policies. In one report, researchers from the University of Illinois at Chicago looked at what would happen if the 27 states without comprehensive smoke-free laws were to enact such laws. In the second report, the same researchers considered the impact if all 50 states and the District of Columbia were to adopt a $1 per pack increase in the cigarette excise tax.

Photo credit: ©bilderbox/fotolia.com

"The bottom line is that strong tobacco control policies are a win-win for state legislators, for the states themselves, and [for] their constituents," said John R. Seffrin, Ph.D., chief executive officer of ACS CAN.

Currently, 23 states and the District of Columbia have enacted comprehensive laws that ban smoking in all bars, restaurants, and workplaces. The remaining 27 states have either less-comprehensive laws or no laws at all in this area. But when the researchers considered the impact if these 27 states were to adopt comprehensive smoking bans, they found that more than 1 million adults would quit smoking, nearly 400,000 children would never start smoking, and smoking-related deaths would fall by 624,000.

On the economic side, those 27 states would see a savings of about $316 million from lung cancer treatment, $875 million from heart attack and stroke treatment, and $128 million from smoking-related pregnancy treatment. And the researchers estimated that Medicaid programs in those 27 states would save a collective $42 million.

The report on tobacco taxes found similar public health and financial gains if a $1 per pack tax increase were enacted around the country. Such a tax would result in 1.4 million adults quitting smoking, 1.69 million children never starting to smoke, and 1.32 million fewer people dying from smoking-related causes. States also could benefit from both decreases in Medicaid spending and increased revenue. The report estimated that the tax would cut Medicaid spending by about $146 million across the states, and would bring in $8.62 billion in new state revenue.

Dr. Seffrin said that the results are attainable. An increasing number of states are adopting smoke-free laws and nearly all the states have increased cigarette excise taxes in recent years.

But he noted the ACS CAN is concerned that the tobacco industry is working to erode current tobacco-control laws at the state level. For example, there have been efforts in several states to add exemptions to the smoke-free laws.

Enacting comprehensive state laws that ban smoking in workplaces and restaurants as well as raising the cigarette tax by $1 per pack across the country could bring in billions in revenue for cash-strapped states, while also saving nearly 2 million lives, according to new estimates from the American Cancer Society Cancer Action Network.

The ACS CAN released two reports on June 15 that examined the public health benefits and economic savings from strengthening state antitobacco policies. In one report, researchers from the University of Illinois at Chicago looked at what would happen if the 27 states without comprehensive smoke-free laws were to enact such laws. In the second report, the same researchers considered the impact if all 50 states and the District of Columbia were to adopt a $1 per pack increase in the cigarette excise tax.

Photo credit: ©bilderbox/fotolia.com

"The bottom line is that strong tobacco control policies are a win-win for state legislators, for the states themselves, and [for] their constituents," said John R. Seffrin, Ph.D., chief executive officer of ACS CAN.

Currently, 23 states and the District of Columbia have enacted comprehensive laws that ban smoking in all bars, restaurants, and workplaces. The remaining 27 states have either less-comprehensive laws or no laws at all in this area. But when the researchers considered the impact if these 27 states were to adopt comprehensive smoking bans, they found that more than 1 million adults would quit smoking, nearly 400,000 children would never start smoking, and smoking-related deaths would fall by 624,000.

On the economic side, those 27 states would see a savings of about $316 million from lung cancer treatment, $875 million from heart attack and stroke treatment, and $128 million from smoking-related pregnancy treatment. And the researchers estimated that Medicaid programs in those 27 states would save a collective $42 million.

The report on tobacco taxes found similar public health and financial gains if a $1 per pack tax increase were enacted around the country. Such a tax would result in 1.4 million adults quitting smoking, 1.69 million children never starting to smoke, and 1.32 million fewer people dying from smoking-related causes. States also could benefit from both decreases in Medicaid spending and increased revenue. The report estimated that the tax would cut Medicaid spending by about $146 million across the states, and would bring in $8.62 billion in new state revenue.

Dr. Seffrin said that the results are attainable. An increasing number of states are adopting smoke-free laws and nearly all the states have increased cigarette excise taxes in recent years.

But he noted the ACS CAN is concerned that the tobacco industry is working to erode current tobacco-control laws at the state level. For example, there have been efforts in several states to add exemptions to the smoke-free laws.

Enacting comprehensive state laws that ban smoking in workplaces and restaurants as well as raising the cigarette tax by $1 per pack across the country could bring in billions in revenue for cash-strapped states, while also saving nearly 2 million lives, according to new estimates from the American Cancer Society Cancer Action Network.

The ACS CAN released two reports on June 15 that examined the public health benefits and economic savings from strengthening state antitobacco policies. In one report, researchers from the University of Illinois at Chicago looked at what would happen if the 27 states without comprehensive smoke-free laws were to enact such laws. In the second report, the same researchers considered the impact if all 50 states and the District of Columbia were to adopt a $1 per pack increase in the cigarette excise tax.

Photo credit: ©bilderbox/fotolia.com

"The bottom line is that strong tobacco control policies are a win-win for state legislators, for the states themselves, and [for] their constituents," said John R. Seffrin, Ph.D., chief executive officer of ACS CAN.

Currently, 23 states and the District of Columbia have enacted comprehensive laws that ban smoking in all bars, restaurants, and workplaces. The remaining 27 states have either less-comprehensive laws or no laws at all in this area. But when the researchers considered the impact if these 27 states were to adopt comprehensive smoking bans, they found that more than 1 million adults would quit smoking, nearly 400,000 children would never start smoking, and smoking-related deaths would fall by 624,000.

On the economic side, those 27 states would see a savings of about $316 million from lung cancer treatment, $875 million from heart attack and stroke treatment, and $128 million from smoking-related pregnancy treatment. And the researchers estimated that Medicaid programs in those 27 states would save a collective $42 million.

The report on tobacco taxes found similar public health and financial gains if a $1 per pack tax increase were enacted around the country. Such a tax would result in 1.4 million adults quitting smoking, 1.69 million children never starting to smoke, and 1.32 million fewer people dying from smoking-related causes. States also could benefit from both decreases in Medicaid spending and increased revenue. The report estimated that the tax would cut Medicaid spending by about $146 million across the states, and would bring in $8.62 billion in new state revenue.

Dr. Seffrin said that the results are attainable. An increasing number of states are adopting smoke-free laws and nearly all the states have increased cigarette excise taxes in recent years.

But he noted the ACS CAN is concerned that the tobacco industry is working to erode current tobacco-control laws at the state level. For example, there have been efforts in several states to add exemptions to the smoke-free laws.

Enacting comprehensive state laws that ban smoking in workplaces and restaurants as well as raising the cigarette tax by $1 per pack across the country could bring in billions in revenue for cash-strapped states, while also saving nearly 2 million lives, according to new estimates from the American Cancer Society Cancer Action Network.

The ACS CAN released two reports on June 15 that examined the public health benefits and economic savings from strengthening state antitobacco policies. In one report, researchers from the University of Illinois at Chicago looked at what would happen if the 27 states without comprehensive smoke-free laws were to enact such laws. In the second report, the same researchers considered the impact if all 50 states and the District of Columbia were to adopt a $1 per pack increase in the cigarette excise tax.

Photo credit: ©bilderbox/fotolia.com

"The bottom line is that strong tobacco control policies are a win-win for state legislators, for the states themselves, and [for] their constituents," said John R. Seffrin, Ph.D., chief executive officer of ACS CAN.

Currently, 23 states and the District of Columbia have enacted comprehensive laws that ban smoking in all bars, restaurants, and workplaces. The remaining 27 states have either less-comprehensive laws or no laws at all in this area. But when the researchers considered the impact if these 27 states were to adopt comprehensive smoking bans, they found that more than 1 million adults would quit smoking, nearly 400,000 children would never start smoking, and smoking-related deaths would fall by 624,000.

On the economic side, those 27 states would see a savings of about $316 million from lung cancer treatment, $875 million from heart attack and stroke treatment, and $128 million from smoking-related pregnancy treatment. And the researchers estimated that Medicaid programs in those 27 states would save a collective $42 million.

The report on tobacco taxes found similar public health and financial gains if a $1 per pack tax increase were enacted around the country. Such a tax would result in 1.4 million adults quitting smoking, 1.69 million children never starting to smoke, and 1.32 million fewer people dying from smoking-related causes. States also could benefit from both decreases in Medicaid spending and increased revenue. The report estimated that the tax would cut Medicaid spending by about $146 million across the states, and would bring in $8.62 billion in new state revenue.

Dr. Seffrin said that the results are attainable. An increasing number of states are adopting smoke-free laws and nearly all the states have increased cigarette excise taxes in recent years.

But he noted the ACS CAN is concerned that the tobacco industry is working to erode current tobacco-control laws at the state level. For example, there have been efforts in several states to add exemptions to the smoke-free laws.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

Medicare payments to physicians will be slashed by 29.4% on Jan. 1 unless Congress acts to avert the scheduled cut, according to an estimate from the Congressional Budget Office.

Last year, Congress passed a 1-year pay fix that kept Medicare fees to physicians at 2010 rates through the end of 2011. Come January, though, physicians will be faced with paying the bill on years of accumulated pay cuts.

The new report from the nonpartisan Congressional Budget Office (CBO) also outlines the costs of various proposals to replace or revamp Medicare’s Sustainable Growth Rate (SGR), the formula that requires annual cuts to physician pay whenever actual spending on physician services exceeds spending targets. For example, if Congress were to throw out the SGR and simply freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. Offering physicians a 2% pay bump in each year through 2021 would raise the price of the fix to $389 billion over the decade.

A somewhat less expensive option would be to reset the SGR instead of replacing it. Under that option, Congress would forgive all spending above the cumulative targets as of the end of 2010. Going forward, 2011 would be the baseline period for the application of the SGR and in 2012 physicians would receive an increase equal to the Medicare Economic Index. That option would cost about $195 billion over 10 years.

Lawmakers on the House Energy and Commerce Committee are considering the options for replacing the SGR. They recently held a hearing in which they solicited ideas from several of the major professional medical societies on what could replace the SGR. Rep. Michael Burgess (R-Tex.), a member of the committee, said that the goal was to enact a permanent solution to the Medicare physician payment problem this year.

GRAPEVINE, TEX. – July brings more restrictions on resident duty hours, but compliance with these requirements can result in reduced hospitalization costs and shorter lengths of stay, if it’s done right.

A study by hospitalists at the University of California, San Francisco’s Benioff Children’s Hospital that analyzed their attempt to cut resident work hours by enlarging care teams and eliminating cross coverage found that a new staffing model reduced hospitalization costs by about 11% and length of stay by about 18%.

Starting July 1, new resident duty-hours requirements from the ACGME (Accreditation Council for Graduate Medical Education) will go into effect, eliminating long shifts for interns. Specifically, interns (PGY-1 residents) will no longer be able to work 30-hour shifts, but will be limited to shifts of no more than 16 hours.

In September 2008, UCSF expanded and reorganized its pediatric inpatient hospitalist service, moving from a traditional call model to a shift-based staffing model. In the process, the hospital eliminated cross-coverage of different teams in favor of dedicated night teams that were subsets of their day teams.

The goal was to increase "patient ownership" by reducing handoffs and to improve patient care by having a more consistent provider overnight, said Dr. Glenn Rosenbluth, a pediatric hospitalist at the hospital. He presented the study results at the annual meeting of the Society of Hospital Medicine.

"The idea was that a resident working a 30-hour shift at 2 in the morning might be more focused on just urgent issues, calls from the nurses, and potentially seeing the call room when they get some down time, whereas someone working a week of dedicated night shifts might be more awake and more interested in advancing care because they’re a member of the primary team," he said.

Prior to September 2008, general pediatrics patients were covered by house-staff teams comprising two interns and one senior resident who were working shifts of up to 30 hours. The interns took call every sixth night and senior residents took call every fifth night. They provided cross-coverage of patients on multiple teams at night. Generally, this meant that one team was working each night and covering for all other teams, Dr. Rosenbluth said.

After the reorganization, they expanded the house-staff teams to four interns per team, with each intern working 3 weeks of day shift and 6 consecutive night shifts. The shifts were generally about 13 hours. The changes allowed them to eliminate cross-coverage and to have a dedicated night team. The attending coverage by hospitalists was unchanged.

To study the impact of the new staffing model, the researchers performed a retrospective, interrupted time series cohort study using concurrent controls. The target group was children who were admitted to the hospital’s general pediatric service. The concurrent control group consisted of surgical patients who were admitted to the same inpatient unit.

Using administrative billing data from the medical center, they analyzed hospitalization costs and length of stay for children who were admitted to the pediatric medical-surgical unit from Sept. 15, 2007, through Sept. 15, 2009. The researchers analyzed data on 280 patients before intervention and 274 patients after intervention. They excluded patients who had spent any time in the pediatric ICU and patients who were on specialty services not covered by either a pediatric hospitalist or a general surgeon. The researchers used multivariate models to adjust for age, sex, the season of year, the admitting diagnosis, and any clustering at the attending level.

They found that for general pediatric patients who were admitted to the medical-surgical unit there was an adjusted rate ratio of 0.82 for length of stay following the intervention. That was an 18% decrease in length of stay from before the intervention. Similarly, hospitalization costs had an adjusted rate ratio of 0.89, an 11% decrease from before the intervention. Among the surgery patients who acted as the control group, there was no statistically significant change in the length of stay and there was a small increase in the cost of hospitalization.

Although there may be incremental costs associated with making the staffing changes needed to comply with the new ACGME duty-hours requirements, Dr. Rosenbluth said the study suggests that these costs may be partially offset by improved care efficiency.

But Dr. Rosenbluth acknowledged that the study did have some limitations. The biggest issue is the limited ability to disentangle the impact of scheduling changes from other changes that were occurring on the unit at the same time. "There was a lot going on, as is the case on all of our units," he said.

The authors reported no disclosures.

GRAPEVINE, TEX. – July brings more restrictions on resident duty hours, but compliance with these requirements can result in reduced hospitalization costs and shorter lengths of stay, if it’s done right.

A study by hospitalists at the University of California, San Francisco’s Benioff Children’s Hospital that analyzed their attempt to cut resident work hours by enlarging care teams and eliminating cross coverage found that a new staffing model reduced hospitalization costs by about 11% and length of stay by about 18%.

Starting July 1, new resident duty-hours requirements from the ACGME (Accreditation Council for Graduate Medical Education) will go into effect, eliminating long shifts for interns. Specifically, interns (PGY-1 residents) will no longer be able to work 30-hour shifts, but will be limited to shifts of no more than 16 hours.

In September 2008, UCSF expanded and reorganized its pediatric inpatient hospitalist service, moving from a traditional call model to a shift-based staffing model. In the process, the hospital eliminated cross-coverage of different teams in favor of dedicated night teams that were subsets of their day teams.

The goal was to increase "patient ownership" by reducing handoffs and to improve patient care by having a more consistent provider overnight, said Dr. Glenn Rosenbluth, a pediatric hospitalist at the hospital. He presented the study results at the annual meeting of the Society of Hospital Medicine.

"The idea was that a resident working a 30-hour shift at 2 in the morning might be more focused on just urgent issues, calls from the nurses, and potentially seeing the call room when they get some down time, whereas someone working a week of dedicated night shifts might be more awake and more interested in advancing care because they’re a member of the primary team," he said.

Prior to September 2008, general pediatrics patients were covered by house-staff teams comprising two interns and one senior resident who were working shifts of up to 30 hours. The interns took call every sixth night and senior residents took call every fifth night. They provided cross-coverage of patients on multiple teams at night. Generally, this meant that one team was working each night and covering for all other teams, Dr. Rosenbluth said.

After the reorganization, they expanded the house-staff teams to four interns per team, with each intern working 3 weeks of day shift and 6 consecutive night shifts. The shifts were generally about 13 hours. The changes allowed them to eliminate cross-coverage and to have a dedicated night team. The attending coverage by hospitalists was unchanged.

To study the impact of the new staffing model, the researchers performed a retrospective, interrupted time series cohort study using concurrent controls. The target group was children who were admitted to the hospital’s general pediatric service. The concurrent control group consisted of surgical patients who were admitted to the same inpatient unit.

Using administrative billing data from the medical center, they analyzed hospitalization costs and length of stay for children who were admitted to the pediatric medical-surgical unit from Sept. 15, 2007, through Sept. 15, 2009. The researchers analyzed data on 280 patients before intervention and 274 patients after intervention. They excluded patients who had spent any time in the pediatric ICU and patients who were on specialty services not covered by either a pediatric hospitalist or a general surgeon. The researchers used multivariate models to adjust for age, sex, the season of year, the admitting diagnosis, and any clustering at the attending level.

They found that for general pediatric patients who were admitted to the medical-surgical unit there was an adjusted rate ratio of 0.82 for length of stay following the intervention. That was an 18% decrease in length of stay from before the intervention. Similarly, hospitalization costs had an adjusted rate ratio of 0.89, an 11% decrease from before the intervention. Among the surgery patients who acted as the control group, there was no statistically significant change in the length of stay and there was a small increase in the cost of hospitalization.

Although there may be incremental costs associated with making the staffing changes needed to comply with the new ACGME duty-hours requirements, Dr. Rosenbluth said the study suggests that these costs may be partially offset by improved care efficiency.

But Dr. Rosenbluth acknowledged that the study did have some limitations. The biggest issue is the limited ability to disentangle the impact of scheduling changes from other changes that were occurring on the unit at the same time. "There was a lot going on, as is the case on all of our units," he said.

The authors reported no disclosures.

GRAPEVINE, TEX. – July brings more restrictions on resident duty hours, but compliance with these requirements can result in reduced hospitalization costs and shorter lengths of stay, if it’s done right.

A study by hospitalists at the University of California, San Francisco’s Benioff Children’s Hospital that analyzed their attempt to cut resident work hours by enlarging care teams and eliminating cross coverage found that a new staffing model reduced hospitalization costs by about 11% and length of stay by about 18%.

Starting July 1, new resident duty-hours requirements from the ACGME (Accreditation Council for Graduate Medical Education) will go into effect, eliminating long shifts for interns. Specifically, interns (PGY-1 residents) will no longer be able to work 30-hour shifts, but will be limited to shifts of no more than 16 hours.

In September 2008, UCSF expanded and reorganized its pediatric inpatient hospitalist service, moving from a traditional call model to a shift-based staffing model. In the process, the hospital eliminated cross-coverage of different teams in favor of dedicated night teams that were subsets of their day teams.

The goal was to increase "patient ownership" by reducing handoffs and to improve patient care by having a more consistent provider overnight, said Dr. Glenn Rosenbluth, a pediatric hospitalist at the hospital. He presented the study results at the annual meeting of the Society of Hospital Medicine.

"The idea was that a resident working a 30-hour shift at 2 in the morning might be more focused on just urgent issues, calls from the nurses, and potentially seeing the call room when they get some down time, whereas someone working a week of dedicated night shifts might be more awake and more interested in advancing care because they’re a member of the primary team," he said.

Prior to September 2008, general pediatrics patients were covered by house-staff teams comprising two interns and one senior resident who were working shifts of up to 30 hours. The interns took call every sixth night and senior residents took call every fifth night. They provided cross-coverage of patients on multiple teams at night. Generally, this meant that one team was working each night and covering for all other teams, Dr. Rosenbluth said.

After the reorganization, they expanded the house-staff teams to four interns per team, with each intern working 3 weeks of day shift and 6 consecutive night shifts. The shifts were generally about 13 hours. The changes allowed them to eliminate cross-coverage and to have a dedicated night team. The attending coverage by hospitalists was unchanged.

To study the impact of the new staffing model, the researchers performed a retrospective, interrupted time series cohort study using concurrent controls. The target group was children who were admitted to the hospital’s general pediatric service. The concurrent control group consisted of surgical patients who were admitted to the same inpatient unit.

Using administrative billing data from the medical center, they analyzed hospitalization costs and length of stay for children who were admitted to the pediatric medical-surgical unit from Sept. 15, 2007, through Sept. 15, 2009. The researchers analyzed data on 280 patients before intervention and 274 patients after intervention. They excluded patients who had spent any time in the pediatric ICU and patients who were on specialty services not covered by either a pediatric hospitalist or a general surgeon. The researchers used multivariate models to adjust for age, sex, the season of year, the admitting diagnosis, and any clustering at the attending level.

They found that for general pediatric patients who were admitted to the medical-surgical unit there was an adjusted rate ratio of 0.82 for length of stay following the intervention. That was an 18% decrease in length of stay from before the intervention. Similarly, hospitalization costs had an adjusted rate ratio of 0.89, an 11% decrease from before the intervention. Among the surgery patients who acted as the control group, there was no statistically significant change in the length of stay and there was a small increase in the cost of hospitalization.

Although there may be incremental costs associated with making the staffing changes needed to comply with the new ACGME duty-hours requirements, Dr. Rosenbluth said the study suggests that these costs may be partially offset by improved care efficiency.

But Dr. Rosenbluth acknowledged that the study did have some limitations. The biggest issue is the limited ability to disentangle the impact of scheduling changes from other changes that were occurring on the unit at the same time. "There was a lot going on, as is the case on all of our units," he said.

The authors reported no disclosures.

Without Congressional action, Medicare payments for dual-energy x-ray absorptiometry will be cut in about half at the beginning of 2012.

But a small, bipartisan group of lawmakers in the House and Senate is pushing to extend DXA payment rates, which were passed as part of the Affordable Care Act and are set to expire at the end of this year, through 2013. Under the ACA, Congress instructed officials at the Centers for Medicare and Medicaid Services to increase DXA payments to 70% of the rate paid by Medicare in 2006.

The Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (H.R. 2020/S. 1096) was introduced at the end of May; it would keep the current DXA payment rate in place for 2 years.

Rep. Michael Burgess (R-Tex.), one of the bill’s sponsors, said that cutting DXA payments is shortsighted. "Osteoporosis and related bone diseases pose a public health issue of enormous proportions, affecting millions of Americans and costing billions of dollars," he said in a statement. "As a physician, I diagnosed and treated many patients during my 25 years of practicing medicine in Texas, and I saw firsthand the way osteoporosis affects patients and their families. The more we can do to promote and encourage education, awareness, and prevention, the better. Why Medicare will pay for a fracture, but not reimburse a reasonable amount for a scan that can prevent that fracture, is beyond me."

Medicare began cutting DXA payments in 2007, after Congress included bone densitometry among a group of high-cost imaging services that were slashed as part of the Deficit Reduction Act of 2005. Since then, physicians have been struggling to cover their costs as reimbursement steadily declined from around $148 per scan in 2006 to about $54 in 2010. Exacerbating the problem is that private insurers have largely followed Medicare’s lead, ratcheting down their reimbursements as well. The ACA brought DXA payments up to about $98.

Physicians’ organizations, including the American College of Rheumatology (ACR) and the American Association of Clinical Endocrinologists (AACE), are urging lawmakers to pass an extension of the current DXA payment rate

Dr. Timothy J. Laing, government affairs committee chair for the ACR and a rheumatologist at the University of Michigan, Ann Arbor, said that if the reimbursement for the test falls below current levels, it will become economically unsustainable for physicians to provide the test in their offices.

Patients still will be able to get a DXA scan in the hospital, but there are downsides to that limited access, Dr. Laing said. Patients are far more likely to get the test if it can be done at the time it’s recommended, he said, adding that providing DXA scans in the office also provides an opportunity for on-the-spot, in-depth counseling from a physician who is knowledgeable about both interpreting the test and treating osteoporosis.

Forcing patients to seek osteoporosis screening in the hospital also means higher Medicare copayments, and usually means longer waits to get the test, said Dr. R. Mack Harrell, secretary of the AACE and an endocrinologist in the South Florida area.

AACE officials are concerned that a drop in reimbursement for DXA will create access problems for Medicare patients, Dr. Harrell said. This is troubling, he said, because osteoporosis testing is a service that is touted by the CMS in its "Your Medicare Benefits" booklet as an important preventive service available under Medicare. "If Medicare is going to make this a priority item for retired people, they have to make it accessible," he said.

Already, many physicians have stopped offering DXA services because of fee cuts, Dr. Harrell said. The good news is that there are still a substantial number of office practices and outpatient centers that can afford to keep their DXA scanners operating at the current reimbursement levels. But Dr. Harrell cautioned that the current payment level is the break-even point for most physicians who are really "hanging on by their fingernails." If rates are cut again, it will become "fiscally impossible" to offer the service in the office, he said.

ACR’s Dr. Laing predicted that getting the legislation passed this year will be an uphill battle. The major issue is the cost of extending the current payment rate.

"Right now, Congress is deadlocked over the budget, so any bill that is introduced that adds costs to anything is going to be difficult." Conversely, Dr. Laing said he is encouraged because the bill has bipartisan support in both the House and Senate.

Without Congressional action, Medicare payments for dual-energy x-ray absorptiometry will be cut in about half at the beginning of 2012.

But a small, bipartisan group of lawmakers in the House and Senate is pushing to extend DXA payment rates, which were passed as part of the Affordable Care Act and are set to expire at the end of this year, through 2013. Under the ACA, Congress instructed officials at the Centers for Medicare and Medicaid Services to increase DXA payments to 70% of the rate paid by Medicare in 2006.

The Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (H.R. 2020/S. 1096) was introduced at the end of May; it would keep the current DXA payment rate in place for 2 years.

Rep. Michael Burgess (R-Tex.), one of the bill’s sponsors, said that cutting DXA payments is shortsighted. "Osteoporosis and related bone diseases pose a public health issue of enormous proportions, affecting millions of Americans and costing billions of dollars," he said in a statement. "As a physician, I diagnosed and treated many patients during my 25 years of practicing medicine in Texas, and I saw firsthand the way osteoporosis affects patients and their families. The more we can do to promote and encourage education, awareness, and prevention, the better. Why Medicare will pay for a fracture, but not reimburse a reasonable amount for a scan that can prevent that fracture, is beyond me."

Medicare began cutting DXA payments in 2007, after Congress included bone densitometry among a group of high-cost imaging services that were slashed as part of the Deficit Reduction Act of 2005. Since then, physicians have been struggling to cover their costs as reimbursement steadily declined from around $148 per scan in 2006 to about $54 in 2010. Exacerbating the problem is that private insurers have largely followed Medicare’s lead, ratcheting down their reimbursements as well. The ACA brought DXA payments up to about $98.

Physicians’ organizations, including the American College of Rheumatology (ACR) and the American Association of Clinical Endocrinologists (AACE), are urging lawmakers to pass an extension of the current DXA payment rate

Dr. Timothy J. Laing, government affairs committee chair for the ACR and a rheumatologist at the University of Michigan, Ann Arbor, said that if the reimbursement for the test falls below current levels, it will become economically unsustainable for physicians to provide the test in their offices.

Patients still will be able to get a DXA scan in the hospital, but there are downsides to that limited access, Dr. Laing said. Patients are far more likely to get the test if it can be done at the time it’s recommended, he said, adding that providing DXA scans in the office also provides an opportunity for on-the-spot, in-depth counseling from a physician who is knowledgeable about both interpreting the test and treating osteoporosis.

Forcing patients to seek osteoporosis screening in the hospital also means higher Medicare copayments, and usually means longer waits to get the test, said Dr. R. Mack Harrell, secretary of the AACE and an endocrinologist in the South Florida area.

AACE officials are concerned that a drop in reimbursement for DXA will create access problems for Medicare patients, Dr. Harrell said. This is troubling, he said, because osteoporosis testing is a service that is touted by the CMS in its "Your Medicare Benefits" booklet as an important preventive service available under Medicare. "If Medicare is going to make this a priority item for retired people, they have to make it accessible," he said.

Already, many physicians have stopped offering DXA services because of fee cuts, Dr. Harrell said. The good news is that there are still a substantial number of office practices and outpatient centers that can afford to keep their DXA scanners operating at the current reimbursement levels. But Dr. Harrell cautioned that the current payment level is the break-even point for most physicians who are really "hanging on by their fingernails." If rates are cut again, it will become "fiscally impossible" to offer the service in the office, he said.

ACR’s Dr. Laing predicted that getting the legislation passed this year will be an uphill battle. The major issue is the cost of extending the current payment rate.

"Right now, Congress is deadlocked over the budget, so any bill that is introduced that adds costs to anything is going to be difficult." Conversely, Dr. Laing said he is encouraged because the bill has bipartisan support in both the House and Senate.

Without Congressional action, Medicare payments for dual-energy x-ray absorptiometry will be cut in about half at the beginning of 2012.

But a small, bipartisan group of lawmakers in the House and Senate is pushing to extend DXA payment rates, which were passed as part of the Affordable Care Act and are set to expire at the end of this year, through 2013. Under the ACA, Congress instructed officials at the Centers for Medicare and Medicaid Services to increase DXA payments to 70% of the rate paid by Medicare in 2006.

The Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (H.R. 2020/S. 1096) was introduced at the end of May; it would keep the current DXA payment rate in place for 2 years.

Rep. Michael Burgess (R-Tex.), one of the bill’s sponsors, said that cutting DXA payments is shortsighted. "Osteoporosis and related bone diseases pose a public health issue of enormous proportions, affecting millions of Americans and costing billions of dollars," he said in a statement. "As a physician, I diagnosed and treated many patients during my 25 years of practicing medicine in Texas, and I saw firsthand the way osteoporosis affects patients and their families. The more we can do to promote and encourage education, awareness, and prevention, the better. Why Medicare will pay for a fracture, but not reimburse a reasonable amount for a scan that can prevent that fracture, is beyond me."

Medicare began cutting DXA payments in 2007, after Congress included bone densitometry among a group of high-cost imaging services that were slashed as part of the Deficit Reduction Act of 2005. Since then, physicians have been struggling to cover their costs as reimbursement steadily declined from around $148 per scan in 2006 to about $54 in 2010. Exacerbating the problem is that private insurers have largely followed Medicare’s lead, ratcheting down their reimbursements as well. The ACA brought DXA payments up to about $98.

Physicians’ organizations, including the American College of Rheumatology (ACR) and the American Association of Clinical Endocrinologists (AACE), are urging lawmakers to pass an extension of the current DXA payment rate

Dr. Timothy J. Laing, government affairs committee chair for the ACR and a rheumatologist at the University of Michigan, Ann Arbor, said that if the reimbursement for the test falls below current levels, it will become economically unsustainable for physicians to provide the test in their offices.

Patients still will be able to get a DXA scan in the hospital, but there are downsides to that limited access, Dr. Laing said. Patients are far more likely to get the test if it can be done at the time it’s recommended, he said, adding that providing DXA scans in the office also provides an opportunity for on-the-spot, in-depth counseling from a physician who is knowledgeable about both interpreting the test and treating osteoporosis.

Forcing patients to seek osteoporosis screening in the hospital also means higher Medicare copayments, and usually means longer waits to get the test, said Dr. R. Mack Harrell, secretary of the AACE and an endocrinologist in the South Florida area.

AACE officials are concerned that a drop in reimbursement for DXA will create access problems for Medicare patients, Dr. Harrell said. This is troubling, he said, because osteoporosis testing is a service that is touted by the CMS in its "Your Medicare Benefits" booklet as an important preventive service available under Medicare. "If Medicare is going to make this a priority item for retired people, they have to make it accessible," he said.

Already, many physicians have stopped offering DXA services because of fee cuts, Dr. Harrell said. The good news is that there are still a substantial number of office practices and outpatient centers that can afford to keep their DXA scanners operating at the current reimbursement levels. But Dr. Harrell cautioned that the current payment level is the break-even point for most physicians who are really "hanging on by their fingernails." If rates are cut again, it will become "fiscally impossible" to offer the service in the office, he said.

ACR’s Dr. Laing predicted that getting the legislation passed this year will be an uphill battle. The major issue is the cost of extending the current payment rate.

"Right now, Congress is deadlocked over the budget, so any bill that is introduced that adds costs to anything is going to be difficult." Conversely, Dr. Laing said he is encouraged because the bill has bipartisan support in both the House and Senate.