Medicare spending on lab tests increased in 2020 due to new spending on COVID-19 testing, while spending on other lab tests fell dramatically, health and service inspectors said social in a report released on Tuesday.
These results raise questions about whether some of these non-COVID-19 tests can be skipped in the future and how these skipped tests will impact beneficiary outcomes in 2022, said Gretchen Jacobson, vice president of Medicare. to the Commonwealth Fund.
Overall, Medicare spending on lab tests under Part B of the program, which covers outpatient visits, lab tests and more, increased by about 4% in 2020, which is consistent with growth levels over the past five years.
But COVID-19 testing, which didn’t exist before 2020, accounted for about 19% of all Medicare outpatient spending on lab tests in 2020, at $ 1.5 billion. When COVID-19 tests are updated, Medicare outpatient spending on lab tests was $ 6.5 billion, $ 1.2 billion lower than overall spending in 2019 and the lowest amount of past five years, said the HHS Inspector General’s office.
Medicare paid for fewer tests overall in 2020 than the year before. The OIG said providers administered 53% fewer non-COVID-19 tests, including cancer screens and drug tests, to Medicare beneficiaries in April 2020 compared to April 2019.
Typical usage patterns picked up in the summer, even increasing in June from the previous year, OIG said. However, that increase did not hold up for the rest of the year, indicating that tests skipped in the spring of 2020 were not caught up later in the year.
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Jacobson wonders if these skipped tests were really necessary. On the other hand, she also wonders if the health of beneficiaries will be worse this year.
“We have seen Medicare spending and use of services return relatively quickly from June 2020, but it will be interesting to see if care has changed at all after people start getting vaccinated,” wrote Jacobson in an email.
More than $ 1 billion in outpatient Medicare spending on lab tests in 2020 was spent on rapid COVID-19 testing alone, the OIG said. The highest test in 2019 – the full group of blood chemicals tests – fell 10% in 2020 and payouts fell 18%. The only non-COVID-19 test that increased from 2019 to 2020 was a microbiology test used to detect an infectious agent, which OIG said was likely used with COVID-19 testing.
The drop in spending for non-COVID-19 tests is also due in part to the reduction in Medicare payment rates for certain tests, as required by a 2018 law, OIG said.
The OIG plans to take a closer look at lab tests and volume drops in 2020, and it will also continue to monitor annual payments for lab tests.