Radiologists Push Back on Reimbursement Cuts

John Commins, for HealthLeaders Media , April 12, 2013

McGinty's study found no intra-service work duplication when different exam interpretations were offered by different physicians in the same group practice. She says small potential efficiencies were found regarding pre- and post-service activities.

Across all scan types this corresponds to a maximum Medicare professional component physician fee reduction of only .95% – 1.87% for the same type of scan. For services from different scan types duplications were too small to quantify, McGinty's study found.

"In a practice like mine… the patient who sustains a head injury and a pelvic injury, if they had a CT scan, that would be read by the neuro-radiologist. And if they had a pelvic fracture, that would be read by a body imager or a musculoskeletal radiologist," McGinty.

"Other than the context that both physicians knowing that the patient had come from a trauma, there is no overlap in terms of what the physicians have to do. There is nothing that makes it easier for that doctor reading that complex pelvic CT… to know that a head CT was done."

McGinty says the ACR is asking CMS to rescind the rule.

"CMS said if they were given additional data to help them understand why there weren't efficiencies across the group practices they would consider it," she says. "We met with CMS on Monday and the paper was out just in time to share it with them. They agreed that they would read it carefully and consider it."

McGinty says ACR believes it's more effective to target reductions in inappropriate imaging by "helping physicians understand what test is appropriate for the clinical set of circumstances they're seeing with the patient."

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2 comments on "Radiologists Push Back on Reimbursement Cuts"

Mtb Walt (7/5/2013 at 8:52 PM)
Tibro Lushi, You say that the problem is that we pay for service in America. What else should we pay for? You do a job and you get paid for it. Your comment also indicates a fundamental misunderstanding of how imaging is reimbursed, as well as the many difficulties being faced by socialist health care systems... not least of which is quality of care. The radiologist is paid to provide the professional interpretation component of the exam. The owner of the machine (such as a hospital) is paid for providing the machine and taking the pictures. Radiologists have been cut 8 times in the last 6 years. This random 25% cut whose justification is refuted by scientific research has just been rammed through by Kathleen Sebelius, of the Obama administration that you so love. As a result, we have large numbers of lesser qualified foreign graduates flooding into radiology as the highly qualified American graduates avoid this foundering but essential field of medicine. Doctors fees make up about 15% of every medical dollar. So if you cut doctors 20% which will certainly result in a significant degradation quality doctors, you have cut only 3% from the medical dollar. That is equivalent to inflation for 1 year.

Tibro lushi (4/12/2013 at 11:47 AM)
The biggest problem in American healthcare is that payment is made per service. For example, the radiologist first gets paid to do the test and then gets paid to do the interpretation of the test. This happens separatedly for every test. Thankfully, Obamacare is moving us towards a more sane way to pay[INVALID]by diagnosis. If the patient has cancer, pay one amount to take care of that cancer, no matter how many tests and interpretations are needed. Europe moved to that long ago. Healthcare there is around 13% of GDP while the US is reaching 20%[INVALID]utterly unsustainable.




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