Dive Brief:

• Cardiologists are bringing in millions of dollars from Medicare for controversial techniques that relieve blockages in the arms and legs, according to a recent New York Times report. 
• The opening of the peripheral arteries and veins of the arms and legs isn't just something that needs to be done in a hospital, where scrutiny is more intense, the Times points out. It can also be done in a doctor’s office.
• According to the Times, medical experts are questioning whether these treatments are necessary, or if exercise and drugs are just as effective. 

Dive Insight:

As The New York Times noted, operations to improve blood flow in the heart, such as balloon angioplasties and stents, have fallen by 30% since 2005, while operations in the peripheral vessels, mainly in the leg, have increased by 66%. In physicians' defense, there is a good case to be made that by performing the procedures outside a hospital: They save money that way. So long as the procedures are warranted. 

There is a delicate balance to be struck here. While oversight of physicians who bill Medicare is critical to the program's financial sustainability, procedures can't be dismissed out of hand without adequate research either. The lesson for physicians here is that scrutiny of of their medical decision-making is only going to increase, and it may soon be the responsibility of the physician to self-audit the cost-benefit of care choices for Medicare patients.