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Data: Actual imaging use far below president's recommended 95 percent utilization rate for Medicare
Date:6/19/2009

Washington, D.C. The amount of time imaging equipment is in use in outpatient settings does not approach use rates President Obama and the Medicare Payment Advisory Commission (MedPAC) recommend Medicare utilize to calculate reimbursement for imaging, according to data recently collected by the Radiology Business Management Association (RBMA), a national association of business professionals in radiology.

The RBMA data, which consist of 261 imaging machines in 46 centers, show, using current Medicare assumptions, that imaging equipment in rural regions of the country operates only 48 percent of the time an office is open, while equipment in non-rural areas operates 56 percent of the time a center is open for business. Neither rural nor urban non-hospital diagnostic imaging providers operate equipment at rates anywhere near the levels the President or MedPAC recommend the Centers for Medicare and Medicaid Services (CMS) use to base reimbursements. President Obama recently recommended CMS base its reimbursement formula on a 95 percent utilization rate for advanced imaging equipment. MedPAC has recommended a 90 percent utilization rate for equipment that costs more than $1 million.

The utilization assumption for advanced imaging equipment is a key component of the Medicare formula used to calculate reimbursements for all Medicare services including life-saving diagnostic imaging. Dramatically increasing the utilization assumption to a level significantly higher than actual use rates would result in a severe cut for imaging reimbursements that will impair access to diagnostic imaging services and cause patients to delay or forgo necessary imaging procedures. These cuts would have a particularly devastating impact on patients in rural regions of the country, causing congestion and delays at the point of care, and forcing physicians to pull back services in their communities.

"Spending on advanced imaging has decreased significan
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Contact: Sarah Mills
smills@powelltate.com
202-585-2084
Powell Tate
Source:Eurekalert

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