By Allison Sit
The American Academy of Dermatology (AAD) is joining with other specialties in speaking out about cuts to the Medicare Physician Fee Schedule for 2025. The physician services cut – nearly 2.83% – is slated to occur despite an estimated 3.5% rise in the Medicare Economic Index, the government’s gauge of the costs of providing physician care for Medicare patients.
“These cuts to Medicare physician payments, which have occurred every single year since 2021, arise from a complex set of budgetary rules and systemic flaws in the requirements that, unless addressed, will continue to threaten physicians’ ability to provide care,” said AAD President Seemal R. Desai, MD, FAAD, in a statement. “These include the budget-neutrality requirement for Medicare mandating that any increase for certain physician services must be balanced by cuts elsewhere with no concern for inflationary pressures. The failure of Medicare physician payments to keep up with inflation is the greatest threat to maintaining patients’ access to care.”
In statement, Bruce A. Scott, MD, president of the American Medical Association (AMA), called the cuts a way for Medicare to “pay us less while costs go up.” The AMA is calling for “systematic reform that makes Medicare payment rational, predictable and sustainable.”
A new study shows melanoma diagnosis via telemedicine is as accurate as an in-person examination. The study, conducted by NYU Langone Health and the Perlmutter Cancer Center, analyzed the effectiveness of SpotCheck, a system which uses dermoscopy.
Nearly 400 skin lesions were analyzed, and all were first identified by patients. Participants underwent a personal and family history survey, and received a physical exam with a dermatologist, who used a dermatoscope and performed a biopsy, if needed. Clinical and dermoscopic images were also sent to a remote team of skin cancer specialists, who made diagnoses based on the same information.
The experts who remotely reviewed all of the samples were 91% accurate in their diagnoses, based on later biopsies, while dermatologists who instead performed in-person evaluations had an accuracy of 93%. Ninety percent of patients were satisfied with the telemedicine experience, and 20% reported that they preferred telemedicine over an in-person specialist appointment. Ninety-seven percent of lesions were later determined by biopsy to be benign.
“Our findings suggest that this method of teledermoscopy may not only help healthcare providers catch potentially dangerous skin cancers early, it may also reduce expensive, anxiety-causing referrals to specialists for benign lesions,” said senior author David Polsky, MD, PhD. “A key advantage of teledermoscopy platforms is that community health workers can be trained to collect images and send them out for expert review. As a result, this technology could be used in the future to offer virtual triage services in walk-in clinics, pharmacies and community centers.”
The researchers plan to identify neighborhoods with higher rates of late-stage melanoma for possible deployment of the SpotCheck system. The results appeared online in the Journal of the American Academy of Dermatology.
