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

tly since 2005 and imaging use has essentially flattened. When it comes to imaging, the curve has already been bent," Tim Trysla, executive director of the Access to Medical Imaging Coalition (AMIC) said. "Any further deep imaging reimbursement cuts will severely disrupt patients' access to diagnostic services. Bureaucratic red tape including long waits for appointments, delays in the waiting room and patients driving long distances will be typical if Medicare spending is reduced by levels proposed by President Obama or MedPAC."

When calculating its reimbursement formula for diagnostic imaging services, the Centers for Medicare and Medicaid Services (CMS) currently assumes that imaging equipment is in use, on average, 50 percent of the available time. The RBMA data suggest the current Medicare utilization rate is similar to the actual rate at which imaging equipment operates.

"If policymakers want Medicare's reimbursement formula to mirror actual imaging equipment utilization rates in both urban and rural practices, our data demonstrate CMS' current use rate assumption is more accurate than what Congress and the Administration are proposing," said Michael Mabry, executive director of RBMA. "Since MedPAC's utilization rate survey was based on only six urban regions, we understand policymakers' need to continuously collect accurate use rate data to inform their reimbursement decisions. RBMA is committed to collecting and providing those data on an ongoing basis."

AMIC contends that MedPAC's 90 percent utilization rate change recommendation is based on a deeply flawed survey. Importantly, MedPAC's recommendation to change the utilization assumption is based on data collected prior to the severe cuts that resulted from enactment of the Deficit Reduction Act of 2005 (DRA), and does not consider the impact on rural providers. MedPAC's survey was limited to six urban areas, two modalities (MR and CT), and to providers operating in 200
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Contact: Sarah Mills
smills@powelltate.com
202-585-2084
Powell Tate
Source:Eurekalert

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