Ben Lauing, Imaging Performance Partnership
My colleague Robin Brand recently spoke at the Children’s Hospital Association’s Radiology Directors Forum in Houston, where she discussed several of the key forces currently impacting pediatric imaging programs. Much of the conversation focused on health care reform, and, in particular, the current state of Medicaid expansion.
While increased eligibility for Medicaid will have a disproportionate impact on children’s hospitals, as Medicaid covers a significant number of uninsured children, Medicaid expansion will impact all providers.
Medicaid expansion’s impact on pediatric volumes, doughnut holes, and reimbursement
Eric Bushlow, Imaging Performance Partnership
Policy makers have long argued that the cost of advanced medical imaging among Medicare beneficiaries has contributed significantly to overall health care cost growth. Recent research presented at RSNA 2012, however, suggests the 2005 Deficit Reduction Act (DRA) dramatically impacted the growth of these services as compared to other health care costs.
The study highlights that before the DRA, advanced imaging was the fastest growing service category, ranking in the 86th growth rate percentile in 2001. However, by 2011 advanced imaging fell to the 2nd growth rate percentile—a testament to the effectiveness of this legislation and potentially demonstrating the impact of more recent appropriateness scrutiny.
These findings add to a growing body of evidence suggesting a significant decline in imaging utilization over the past decade—a trend uncovered in the March 2012 MedPAC report.
Growth rate of advanced imaging slows dramatically since DRA
Shaun Lillard, Imaging Performance Partnership
A report last week from the Government Accountability Office (GAO), the nonpartisan investigatory and auditing agency for Congress, found that in 2010 providers for advanced imaging services made close to 400,000 more referrals than they otherwise would have if they had not held a financial interest in the imaging equipment.
Self-referrals in advanced imaging services costing Medicare millions