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Current trends in Massachusetts do not bode well for radiologists.

The Boston Business Journal last week looked at the effect of the state’s 2006 health-care reform on health care jobs. (You can find the article here; a subscription is required. For a DOTmed News look at the article’s findings, click here.)

The Affordable Care Act, aka Obamacare, largely followed the Massachusetts model. The BBJ article focuses on one Chris Murphy. His experience may foretell difficult days ahead nationally for radiologists and associated professionals:

The X-ray technician at Quincy Medical Center says he is seeing fewer patients as more work moves to lower-cost outpatient radiology centers. Six or seven years ago, he says, there was a surplus of good jobs for people like him. Now, he said, opportunities are shrinking, as workers who leave radiology departments aren’t replaced.

Why the gloomy outlook? The transition from fee-for-service reimbursement to pay-for-performance—which the Affordable Care Act is also pushing. Hospitals used to make money on every scan at in-house radiology departments. With pay-for-performance, that’s not necessarily the case. Murphy put it this way:

Diagnostic studies help subsidize Medicare and Medicaid, which is underpaid by the government. Without it, it’s very hurtful to hospitals that are already struggling.

It’s not a case of jobs simply shifting from hospitals to stand-alone clinics. Pay-for-performance means fewer scans overall, and thus fewer jobs. And if stand-alone clinics charge less per scan, that means less income for those who perform and read the scans.

A Boston-area cancer survivor, patient advocate, and blogger known as e-Patient Dave wrote about shopping for a chest CT scan. Such a scan had cost him $1,484 at a hospital. He found that Salem Radiology in Salem, New Hampshire, a half hour from his home, charged $520, including the lab work and the radiologist’s report.

That $964 difference came out of multiple pockets. One of them undoubtedly was the radiologist’s.

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An X-ray van rumbles through London’s streets, seeking an old and resurgent enemy: tuberculosis. For details, see our Facebook page.

Related CME seminar (up to 42.5 AMA PRA Category 1 credits™): UCSF Radiology Review: COMPREHENSIVE IMAGING


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