Medicare spending on laboratory tests rose in 2020 due to new spending on COVID-19 tests, while spending on other lab tests fell sharply, Health and Human Services inspectors said in a report released Tuesday.
These results raise questions about whether some of these non-COVID-19 tests may be skipped in the future and how these skipped tests will affect recipients’ results in 2022, said Gretchen Jacobson, vice president of Medicare at the Commonwealth Fund.
Overall, Medicare’s spending on laboratory tests through Part B of the program – which covers outpatient visits, laboratory tests and more – increased by around 4% by 2020, which is in line with growth levels over the last five years.
But COVID-19 tests, which did not exist until 2020, accounted for about 19% of all Medicare outpatient lab tests in 2020 to $ 1.5 billion. When COVID-19 tests are discounted, Medicare’s outpatient costs for laboratory tests were $ 6.5 billion, $ 1.2 billion less than total expenses in 2019 and the lowest amount in the last five years, the HHS Office of Inspector General said.
Medicare paid for fewer tests in total in 2020 than in the previous year. OIG said providers administered 53% fewer non-COVID-19 tests – including cancer screenings and drug tests – to Medicare recipients in April 2020 than in April 2019.
Typical usage patterns were resumed in the summer and even increased in June compared to the previous year, OIG said. However, this increase did not hold for the rest of the year, indicating that skipped tests in the spring of 2020 were not made up later in the year.
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Jacobson wonders if these skipped tests were actually necessary. On the other hand, she also questions whether there will be poorer recipient health this year as a result.
“We saw Medicare spending and use of services return relatively quickly from June 2020, but it will be interesting to see if the care changed at all after people started getting vaccinated,” Jacobson wrote in an email.
Over $ 1 billion of Medicare outpatient costs for laboratory tests in 2020 were for rapid COVID-19 tests alone, OIG said. The top test in 2019 – the comprehensive group of blood chemicals test – fell by 10% in 2020, and payments fell by 18%. The only non-COVID-19 test that increased from 2019 to 2020 was a microbiological test used to detect an infectious agent that OIG said was likely used in conjunction with COVID-19 tests.
The cost decline for non-COVID-19 tests is also due in part to reduced Medicare payment rates for some tests, as required by a 2018 law, OIG said.
OIG plans to investigate even more closely which laboratory tests and falls in volume by 2020, and it will also continue to monitor annual payments for laboratory tests.