Doctors' use of new medical tests increase Medicare spending

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Doctors who use new medical devices to perform tests in their offices are quickly driving up Medicare spending, according to a report in The Wall Street Journal.

Some of the fastest-growing Medicare costs are from doctors who use new tests on their patients, according to an analysis by the newspaper. Doctors are performing tests for everything from determining whether patients sweat in response to a low-voltage current as a way to diagnose nerve damage to measuring the saltiness of tears to diagnose whether patients’ eyes are too dry, the newspaper reported. Doctors are then collecting from Medicare for the tests.

For instance, costs for the sweat test, which can diagnose an unusual neurological condition, rose in recent years across the country after a device became available that allows doctors to perform the test in their offices, The Journal said. Medicare paid out $16.7 million for the test in 2014, a 10-fold increase in two years.

It's not uncommon to see increases in Medicare billing after the introduction of medical devices that allow doctors to provide services in their offices that they used to refer outside their practice, the newspaper said. Its analysis of Medicare billing data showed that four of the top 10 fastest-growing Medicare services from 2012 to 2014 were from new devices. Medicare paid $135 million in 2014 for those four services, up from $123.5 million in 2012.

But it’s often a small number of doctors billing Medicare the most, the newspaper found. For all four services, a small number of doctors adopted the services much faster than other physicians, so that less than 10 percent of doctors accounted for more than half the increase in spending for each service.

For Medicare it’s a balance between paying for patient access to new therapies that can benefit them and the true value of new medical devices, the newspaper said. “We don’t want to deny lifesaving technologies or even things that would make older people feel better,” Rita Redberg, M.D., a cardiologist at the University of California, San Francisco, who chairs a Medicare advisory committee that looks at new technology, told The Journal. “But, right now, the balance is leaning toward just paying for things.”

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