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HomeHealthcareOIG: Medicare Half B Spending on Lab Assessments Rose 17% in 2021

OIG: Medicare Half B Spending on Lab Assessments Rose 17% in 2021

Medicare Half B spent $9.3 billion on laboratory exams in 2021, a latest report from the Workplace of Inspector Basic (OIG) discovered. This represents a 17% enhance from 2020, when spending was at $8 billion.

The OIG carried out this examine by analyzing claims knowledge for lab exams carried out in 2021 and paid for by the Facilities for Medicare and Medicaid Companies beneath the Medical Laboratory Payment Schedule.

The 17% enhance is the most important soar since OIG started monitoring lab spending in 2014. This enhance was as a consequence of increased quantity for 3 check sorts: Covid-19 exams, genetic exams and chemistry exams.

Medicare Half B spent $2 billion on Covid-19 exams in 2021, a 29% enhance from 2020. Greater than 10 million enrollees acquired at the very least one Covid-19 check that Medicare Half B paid for.

“The Covid-19 pandemic continued to have an effect on Medicare Half B spending on lab exams,” the report mentioned. “Spending on Covid-19 exams elevated in 2021, pushed by extra individuals receiving extra exams.”

This rise in spending on Covid-19 exams could not have continued into 2022, nevertheless.

“Seeking to 2022, it’s possible that the elevated availability of at-home Covid-19 exams might have an effect on total Medicare Half B spending for lab-performed exams,” OIG mentioned.

Moreover, spending on 4 forms of genetic exams rose by 56% to $1.9 billion in 2021, in comparison with $1.2 billion in 2020. This exceeded even pre-pandemic ranges: in 2019, spending on genetic exams was $1.5 billion.

Spending on chemistry exams additionally elevated. In 2021, Medicare Half B spent $2.1 billion on chemistry exams, an almost 11% enhance from 2020 at $1.9 billion. Nonetheless, that is under pre-pandemic ranges. In 2019, Medicare Half B spent $2.4 billion on chemistry exams. This has some regarding implications, OIG mentioned.

“The second yr in a row of low quantity for chemistry exams raises questions in regards to the pandemic’s long-term impression on Medicare enrollee well being,” the report acknowledged. “Though quantity elevated from 2020 to 2021, it didn’t absolutely return to pre-pandemic ranges, which might point out that persons are not in search of the routine or preventive care appointments the place these exams are ordered. Analysis means that delays of such exams might have a long-lasting impression on individuals’s well being.” 

The highest 25 exams price Medicare Half B $5.5 billion, or 59% of Medicare Half B’s complete spending on lab exams in 2021, the report discovered.

Picture: Julia_Sudnitskaya, Getty Pictures



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