ACR to Joint Select Committee: Imaging Cuts May Increase Costs

Imaging cuts in the Obama administration’s deficit reduction proposal would restrict patient access to care and may actually increase costs, asserts the American College of Radiology (ACR) in a statement released today. “The ACR urges the Joint Select Committee on Deficit Reduction to reject the administration’s imaging recommendations and work with ACR and other imaging stakeholders to create policies that ensure safe, appropriate care, promote quality, and protect patient access,” the statement says. The proposal includes changes to the imaging equipment utilization rate and a Medicare prior-authorization program for advanced diagnostic imaging services; such imaging cuts will total $1.3 billion over 10 years. Imaging providers have, the statement points out, already endured more than $5 billion in reimbursement cuts over the past five years, with payment rates for many life-saving CT and MRI scans slashed by up to 60%. Moreover, the ACR alleges, this latest round of cuts will likely force many suburban and rural imaging providers to close, driving imaging care back to larger metropolitan medical centers and causing patients to endure longer commutes and wait times to obtain appointments. “Since Medicare reimbursement and patient co-pays can be higher for imaging services performed in hospitals than in freestanding centers or doctors’ offices, this may drive up costs as it restricts access,” the statement reads. The ACR also deems the present equipment utilization rate assumption of 75% “artificially high”, noting that a survey by the Radiology Business Management Association (RBMA) shows that the national average rate is only 54%. The higher the utilization rate assumption, the lower the per-scan Medicare reimbursement and the greater the difference between a facility’s actual utilization rate and the Medicare assumption, the greater the cut, the society points out. A prior authorization program for advanced imaging in Medicare would have third party gatekeepers (RBMs) – not doctors and patients – decide whether patients receive needed scans. “Aside from this disruption in care, many policy experts believe that, once all vendor fees and associated expenses are included, use of RBMs may actually cost Medicare money – not produce savings,” the statement says. Finally, the ACR deems “inaccurate” the assertion that increased imaging usage necessitates the proposed cuts. Spending on medical imaging, according to the society, is unlike that for most other Medicare services in that it remains at roughly the same level as in 2004. “A Moran Company review of claims data proves that imaging growth in Medicare is less than 2% per year, and advanced imaging growth is roughly half that of three years ago,” the statement concludes. “Blind cost-cutting based on faulty assumptions can only hurt access to care and ultimately reduce the quality of care that Americans receive.” To read more about the deficit reduction plan, click here: http://www.acr.org/SecondaryMainMenuCategories/NewsPublications/FeaturedCategories/CurrentACRNews/archive/Obama-Defecit-Reduction-Plan-.aspx To read the survey, click here: http://rightscanrighttime.org/wp-content/uploads/2009/08/imaging-equipment-utilization-rate-report_final-16jul09.pdf>