COVID-19 Testing Drives Medicare Lab Test Costs In 2020

Medicare laboratory testing costs have increased in 2020 due to new costs for COVID-19 tests, while other laboratory testing costs have dropped significantly, health and social services inspectors said. report released on Tuesday.

These results raise questions about whether some of these non-COVID-19 tests can be missed in the future and how these missed tests will affect beneficiary results in 2022, said Gretchen Jacobson, Medicare vice president at the Commonwealth Foundation.

Overall, Medicare spending on lab tests under its Part B program, which covers outpatient visits, lab tests, and more, increased by about 4% in 2020, in line with growth rates over the past five years.

But COVID-19 tests, which were not available until 2020, accounted for about 19% of Medicare’s total outpatient laboratory test spending in 2020, at $ 1.5 billion. Excluding COVID-19 tests, Medicare’s outpatient laboratory test costs were $ 6.5 billion, $ 1.2 billion less than total costs in 2019 and the lowest in five years, according to the Office of the Inspector General of HHS. …

Medicare paid for fewer tests in 2020 than in the previous year. OIG said service providers performed 53% fewer non-COVID-19 tests in April 2020, including cancer screening and drug tests, compared to April 2019.

Typical usage resumed in the summer, OIG said, and even increased in June from the previous year. However, this increase was not sustained throughout the rest of the year, indicating that the missed spring 2020 tests were not replenished later this year.

Jacobson wonders if these missed tests were really necessary. On the other hand, she also wonders if the health of the beneficiaries will deteriorate as a result this year.

“We saw Medicare spending and service use return relatively quickly starting in June 2020, but it will be interesting to see if treatment has changed at all since people started getting vaccinated,” Jacobson wrote in an email.

More than $ 1 billion in outpatient Medicare spending on laboratory tests in 2020 went to COVID-19 rapid tests alone, according to OIG. The main test in 2019 – a comprehensive analysis of a group of chemicals in the blood – fell 10% in 2020, while payments fell 18%. The only non-COVID-19 test that has increased from 2019 to 2020 is a microbiological test used to detect an infectious agent, which OIG says was likely used in conjunction with COVID-19 tests.

The cut in costs for non-COVID-19 tests is also partly due to lower Medicare payment rates for some tests, as required by the 2018 law, OIG said.

OIG plans to look even more closely at what lab tests and how much to drop in 2020, and will continue to track annual payments for lab tests.

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