Imaging reimbursement cuts: What's the impact on patient care?

Since the passage of the Deficit Reduction Act in 2006, radiologists have been hammered by one reimbursement cut after another. In fact, according to the American College of Radiology, medical imaging has been cut a dozen times in the last seven years.

We know that these cuts have certainly had an impact on imaging costs and utilization. What we're not so sure about is the impact these cuts may have on individual patient care.

We also know that these cuts continue to be implemented, despite compelling evidence showing that medical imaging no longer is a driving force in escalating healthcare costs. Now a study in the Journal of the American College of Radiology adds more fuel to that fire. In that study researchers found that not only is medical imaging spending per Medicare enrollee declining, but that the percentage of patient visits that result in imaging studies has--and continues--to decline, as well.

According to researcher Danny Hughes, the results of the study should lead to a reassessment--if one is still needed--of assumptions concerning diagnostic imaging and escalating health costs.

Hughes and his colleagues certainly are not the first to come to such a conclusion. Last year, for instance, a study led by David C. Levin, M.D., determined that Medicare imaging costs had been cut by 21 percent from 2007 to the end of 2010.

Yet, cuts keep coming. The passage of "fiscal cliff" legislation earlier this year, for example, includes $800 million in Medicare cuts to advanced medical imaging services, as well as $300 million in radiation oncology, both of which go into effect next January.

Radiologists have been complaining that enough is enough, but the Harvey L. Neiman Health Policy Institute (which conducted the most recent study), has made a point of arguing that concerns about cuts should transcend issues regarding reimbursement and declining utilization. For example, in its first report, the Neiman Health Policy Institute, noted that while imaging use and spending has been declining, hospital stays have increased, with some studies showing a correlation between imaging and hospital admissions and length of stay.

More studies of this type are necessary. If policymakers and regulators still think it's a good idea to go after medical imaging reimbursement, such research will at least help to create an understanding, as Hughes put it, of "the whole picture of imaging's relationship to healthcare cost trends and quality of care." - Mike  @FierceHealthIT