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If Health Law Survives, Imaging Tsunami Next?

June 14, 2012
Written by: , Filed in: Practice Management
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If the Supreme Court upholds the Patient Protection and Affordable Care Act, then warm up the scanners. A consultant says the sudden addition of nearly 37 million Americans to the ranks of the insured will cause imaging to increase by 13.6 percent a year over the next few years after the law’s provisions kick in.

That analysis comes from Brian Baker, president of Regents Health Resources, an imaging services consultant based in Franklin, Tennessee. According to DOTmed News, Baker summed up the implications this way:

What we’re left with is, number one, as an industry, do we have the capacity to take on this additional utilization? And, number two, how is it going to be paid for?

Regents based its forecast on 2010 numbers for imaging exams and Kaiser Family Foundation population data. It figured there are 49.4 million truly uninsured people in the United States—those with no private insurance nor Medicare or Medicaid coverage. But about a quarter of those receive charity or other unpaid care, leaving almost 37 million people who would newly enter the health-care market if the health law’s provisions stand.

The company further tweaked its estimate of potential new imaging usage by adjusting for differing utilization rates according to age groups and imaging modality.

Baker said he considers his estimate conservative. It doesn’t take into account the growth of the population in general or of the over-65 population in particular. Those older patients use imaging services at six times the rate of younger folks, he said.

Some states, such as Texas, California, and Georgia, have large uninsured populations. They could be in for big imaging increases that will strain, if not overwhelm, capacity. In Texas, according to the Regents forecast, CT and MRI services together could grow nearly 25 percent.

The increased business may or may not be a boon to radiologists, Baker said, depending on the reimbursement levels provided by private insurance plans, as well as Medicare and Medicaid.

And, of course, if the Supreme Court invalidates all or much of the law, he said, “All these forecasts go away.”

Related seminar: UCSF Radiology Review: CLINICAL HIGHLIGHTS (all-new release)

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