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The Boston Globe



Cutting health care costs: A test of nerves

A NEW Medicare-cost-cutting effort that will pay neurologists less for some procedures has the whole profession up in arms, but that doesn’t mean the new policy is wrong. Similar disagreements are likely to occur with some frequency over the next few years, as the Affordable Care Act goes forward and Medicare officials — necessarily — focus more and more on curbing health care costs.

As the Globe’s Chelsea Conaboy reportedly recently, the neurologists are upset over a reduction in the amount Medicare will pay for testing nerves. The Centers for Medicare and Medicaid Services will be cutting reimbursements for some tests in half, and with good reason. Neurologists bill for each nerve tested, but the charge per nerve includes costs that occur only once during an appointment, such as the time a doctor spends greeting a patient and explaining the procedure. A doctor who tests more than one nerve in a visit, as often happens, is effectively paid multiple times for the same slice of time.

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