The costs of health care have continued to skyrocket despite the many changes made as a result of the implementation of the Patient Protection and Affordable Care Act. Commonly known as “Obamacare”, the Affordable Care Act has opened up opportunities for doctors to explore more in-office services, with even family practice doctors performing a lot of diagnostic tests in-house that were formerly referred to other labs and facilities. One of the primary reasons for this increase has been the new medical devices that have become available for doctors to use to perform tests and analyze samples in right in their offices. Besides the obvious practical value for patients, and with the possibility of diagnosis for early stage illnesses and conditions increasing substantially, there was also a substantial rise in the billed costs of Medicare services. As in-office devices become a more important part of medical practices, the potential profits for doctors are also becoming more apparent.
How Medical Devices Help to Boost Medicare Spending
Medicare sets the pricing on medical services on an annual basis, using projections for thousands of different health care services. They calculate the amount of time each particular service will require to be performed, as well as the total cost for the equipment and anything related to the service. Using this information, they set a full price for the service, as well as what the payment for the doctors will be. Generally, these prices stay within a set range, but the appearance of new devices along with their accompanying tests and services, can disrupt these set prices and require Medicare regulators to makes estimates.
Medical technology is always advancing, and recent improvements have naturally lead to a greater interest in services such as genetic testing. Doctors are always searching for better science, better medicine, and are eagerly taking advantage of the new opportunities that the latest medical devices offer. Also, financial incentives have encouraged doctors to break through some bonds, and explore and embrace new technology.
Some of the newest medical devices offer physicians the ability to test for illnesses far earlier than previously, and from right inside their offices. These tests are of particular value to elderly patients, not just physically but psychologically as well. Early detection of illness can not only give seniors a head start on treatments, often allowing less invasive approaches that would be impossible later but also gives them the psychological benefits of hope and peace of mind as opportunities for treatment and improved health are laid out.
Tear Osmolarity
One of the fastest-growing medical services of the past four years measures tear osmolarity. Tear osmolarity indicates the amount of saline present in the tears, and this particular test can help doctors determine whether or not a patients’ eyes are too dry. Dry eyes, which affects almost 70% of older people, are not only uncomfortable but can also be indicators of a host of other illnesses and conditions, from allergies and vitamin deficiencies to problems with medications and chronic conjunctivitis. TearLab Corporation introduced their first in-office test machines that allow doctors to perform the testing service while patients are in their offices. The test is meant to help doctors diagnose patients with dry eyes.
Nearly 3,000 eye doctors used this test on their patients, and billed Medicare for a total of approximately $15 million in 2014, a massive increase from the $1.75 million billed just two years before when the test was first introduced to doctors and Medicare first began to cover its usage.
The Sweat Test
Another new test that is attracting many doctors and patients is a neurological test that involves measuring an individual’s sweat threshold by touching a low-voltage current to their skin. This sweat test can help doctors detect very early nerve damage, value when screening for diabetes and a host of other diseases and conditions that include nerve damage as a symptom. Like the tear tests, these sweat threshold tests bring an immense profit in for the doctors using the equipment. Nearly $17 million was paid out for the test in 2014 alone, 10-times as much as that from 2012.
Electronic Brachytherapy
Yet another of the fast-growing medical technologies that burst onto the scene in recent years is electronic brachytherapy or EBT. When it originally came on the scene, Medicare contractors assumed that the machine, which uses small bits of X-ray energy when treating cancer. Back then, the contractors set their prices assuming it would only be used for complicated procedures to treat breast cancer. Soon, however, dermatologists began using the machine to treat some kinds of melanoma. Because of this, the claims for EBT usage grew from $7.8 million in 2012 to $95 million in 2014, and according to Medicare claims records, most of those claims were processed for skin cancer.
Medicare Spending and Marketing
As Medicare contractors review many of these tests and the claim reimbursement prices being assigned to each one, the discussion turns to why these prices are so high and questions about the fair usage of these tests does arise. For many of the doctors using the tests, the issue is at least in part income. Meager as it may seem in the scope of a physician’s annual income, the $3,000 to $4,000 that has been set for EBT tests, for example, is far more practical.
For many doctors, the use of these tests for patients is all about preventing fatal issues that can arise when the nervous system begins to deteriorate. Diabetics, for example, often suffer from neurological issues, including autonomic neuropathy in which involuntary functions such as sweating or breathing. With diabetic nerve damage, however, there are few outward signs of the injury going on.
Conclusion
Doctors have begun exploring new avenues of care since the passing of the Affordable Care Act, and are recognizing the importance of in-office care. A major contributor to this new perspective has been the new reimbursement policies of Medicare, which provide for more generous payment for many in-office tests and procedures, especially if they involve the use of new types of medical devices. These medical devices use innovative testing and treatment options to help doctors detect and prevent illness in a variety of ways. Whether measuring the salinity of tears or treating skin cancer with X-rays, these new medical services are leaving a lasting mark on the health industry, and on the Medicare spending history. As we move forward, and more and more innovative technology makes its way into health care, we can look forward to more changes to how we treat illnesses and more fluctuations in the cost of getting and keeping healthy.
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