America’s Amputation Crisis May Soon Get Much Worse

Few medical procedures are as life-altering as an amputation. But statistics show hundreds of thousands of Americans have their limbs surgically removed each year because they don’t have access to adequate vascular screening and care.

In the rural communities of North Carolina that we serve, the nearest “in-hospital” alternative to our office-based treatment locations is at least 2 to 3 hours away, which can result in delays in care that lead to poor clinical outcomes. The patients we serve are living with vascular diseases such as peripheral artery disease (PAD) and critical limb ischemia (CLI), and many of them are at risk for experiencing major amputations as a result of diabetes-related PAD. In fact, data show living in an underserved North Carolina community is associated with a 29% increase in the odds of undergoing major limb amputation.

The issue extends far beyond North Carolina. PAD, which is related closely to diabetes, obesity, and kidney disease, affects more than 20 million Americans, and communities across the country have limited or no options for patients in need of care for PAD and other serious vascular conditions. This needs to change.

The vast majority of non-traumatic amputations related to PAD and CLI — some 85% — could be prevented if patients are able to access timely interventions. Proper vascular care remains frustratingly out-of-reach for many Americans, especially those who live in rural areas or individuals who identify as non-white. Protecting access to outpatient vascular services is critical to reducing amputation, especially for these high-risk populations.

Unfortunately, the problem could soon get much worse. Despite well-documented disparities in vascular care, CMS recently proposed severe cuts to in-office revascularization services used to treat PAD, which will further marginalize our patient population by encouraging healthcare consolidation, limiting patient access, and accelerating the amputation crisis.

The CMS physician fee schedule proposed rule for CY2022 calls for 23% payment cuts to in-office revascularization services. CMS has tried to justify the cuts by pointing to requirements that offset spending increases in one area with decreases in another. Against logic, CMS cites Bureau of Labor Statistics’ data to justify increases for evaluation and management, yet ignores that same data, which show that every specialty under the physician fee schedule — including cardiology, interventional radiology, and vascular surgery — should receive increased payment.

In order to prevent amputations, which total an estimated 200,000 annually in the U.S. because of PAD and CLI, more Americans need access to proper screening and revascularization services. Performed either in the hospital or in the outpatient setting, revascularization involves removing plaque from a patient’s arteries or inserting devices to keep the blood vessels open. Patients often prefer to receive such services in independent doctor’s offices, which tend to be more convenient, less expensive, and closer to home than hospitals.

When patients have access to limb-salvaging healthcare, physicians can successfully prevent major amputations. Yet, too many patients never receive a vascular evaluation, much less revascularization, prior to their amputation.

The real-world impact of the proposed Medicare cuts would be devastating. If finalized, this would add a huge, unexpected strain on outpatient providers. Combined with the challenges and burdens caused by the ongoing COVID-19 pandemic, the severe Medicare cuts could force many office-based cath labs to close. If access to outpatient vascular care is limited by the cuts, as is likely, fewer Americans will have access to the limb preservation care that patients living with PAD so urgently need. If outpatient locations are forced to close, already vulnerable patients will be forced to travel a great distance to the nearest major hospital. If they don’t have the means or information to do so, they won’t receive the care they need to save their lower limbs and potentially even their lives.

Healthcare policymakers need to recognize the importance of the payment policies supporting the delivery of quality, community-based vascular care. CMS should revise its plans to cut vascular care services by 23%. Failure to do so will cause more Americans to needlessly lose their limbs, leading to higher costs, worse patient outcomes, and greater health disparities.

Sreejit Nair, MD, is board-certified in vascular medicine, vascular interventional radiology, and endovascular procedures. Ashwani Sastry, MD, is an interventional cardiologist triple board certified in cardiovascular diseases, interventional cardiology, and endovascular medicine. Nair and Sastry run Sunrise Vascular, a practice in rural North Carolina to reach vascular disease patients with limited access to care.

Disclosures

Sunrise Vascular receives Medicare funding.

Note: This article have been indexed to our site. We do not claim ownership or copyright of any of the content above. To see the article at original source Click Here

Related Posts
What Causes Hiccups—And 6 Ways to Stop Them thumbnail

What Causes Hiccups—And 6 Ways to Stop Them

Ever get hit with a bout of the hiccups only to feel embarrassed, like they should be a thing adults are over? After all, they don’t serve any purpose at all, other than seemingly to make social situations awkward.This theory isn’t far off from the truth — hiccups pretty much are just a physiological quirk.A…
Read More
Ramalan Zodiak Hari Ini 4 Februari: Gemini Pikirkan Sebelum Bicara, Cancer Jangan Takut Mengambil Risiko thumbnail

Ramalan Zodiak Hari Ini 4 Februari: Gemini Pikirkan Sebelum Bicara, Cancer Jangan Takut Mengambil Risiko

BAGAIMANA peruntungan zodiakmu hari ini? Melansir horoscopefriends, berikut ramalan zodiak hari ini untuk Gemini dan Cancer. GEMINI Kamu cenderung tidak bergerak dan berpikiran sempit dalam pandanganmu, dan ini membawa kamu ke dalam konflik dengan orang-orang di sekitar kamu yang memiliki pendapat yang berbeda. Namun, planet-planet akan membantumu menemukan solusi mendesak untuk masalahmu. Dengarkan pendapat orang…
Read More
Dave Bautista Looks Unrecognizable in Throwback Photo thumbnail

Dave Bautista Looks Unrecognizable in Throwback Photo

Dave Bautista is pretty easy to spot in a crowded room. The wrestler-turned-actor stands 6'4" for a start, covered in tattoos, and has been rocking a variation of the same shaved or cropped hairstyle for years now. But it wasn't always that way. In a recent throwback photo posted to Instagram, Bautista took fans back
Read More
[New Book] The French Revolution's Terror Boat, etc. thumbnail

[New Book] The French Revolution's Terror Boat, etc.

프랑스 혁명의 공포정(휴 고프, 주명철 옮김, 여문책, 2만원)=아일랜드의 프랑스혁명사 연구자가 프랑스혁명 기간 약 18개월간 이어진 ‘공포정’을 분석한 학술서. 저자는 공포정을 “협박, 대량 체포, 처형으로 민간인을 두렵게 만들고 마음대로 통제하면서 특정한 목적을 달성하려는 체제”라고 설명한다. 저자는 공포정을 탄압과 중앙집권으로만 조명하지 말고, 새로운 사회질서를 수립하려 한 측면도 함께 들여다볼 필요가 있다고 주장한다. 기묘한 중국사(왕레이(王磊), 고상희 옮김, 에쎄,…
Read More
The EU wants to repay the debt of the development fund thanks to new taxes thumbnail

The EU wants to repay the debt of the development fund thanks to new taxes

Die ersten Auszahlungen aus dem EU-Aufbaufonds sind in den von der Pandemie gebeutelten Ländern wie Italien angekommen. Wie die dafür aufgenommenen gemeinsamen Schulden zurückbezahlt werden sollen, wird die Kommission am Mittwoch erklären. Ihre Ideen sind umstritten. Es wird viel Geld verschoben innerhalb der EU, doch wer für die Zahlungen geradestehen muss, ist nicht immer von…
Read More
Index Of News
Total
0
Share