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Sky Is Falling? Well, Payments Are, At Least

August 16, 2012
Written by: , Filed in: Practice Management
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“The problems are still the same from last year. They are only intensified.”

That cheery thought seemed to encapsulate the theme of the annual meeting of AHRA: The Association for Medical Imaging Management, which took place this week in Orlando, Florida. The speaker was Lawrence Muroff, MD, president and chief executive officer of Imaging Consultants Inc. of Tampa, Florida.

Dr. Muroff told his audience of radiology administrators:

It’s clear that it’s a nasty world out there, but in any turbulence there’s opportunity.

According to coverage of the meeting by DOTmed News, speakers seemed to focus more on the turbulence than the opportunity. Dr. Muroff discussed upcoming cuts in Medicare reimbursements, for both the technical and professional components of imaging. And he mentioned increases in equipment utilization rates, consolidation of interventional radiology and CT codes, and adoption of Medicare rates by other insurers.

The rise of accountable care organizations will increase downward pressure on reimbursement rates. Doctors in an ACO share responsibility for a patient’s care and are paid via some sort of group model that includes bonuses for keeping costs down.

“This is going to happen, folks, I promise,” said Shawn McKenzie, CEO of Ascendian Healthcare Consulting of Sacramento, California. “And insurance companies sure like it.”

Vendors of imaging equipment are also getting squeezed through such things as the Hospital Value-Based Purchasing Program that the Centers for Medicare and Medicaid Services are planning to implement in October. Laurel Sweeney, senior director of global reimbursement for Philips Healthcare, described the general outlook for the health care system this way:

Basically, you’ve got winners and losers. You’ve got a bucket of money, and money will be given back to the winners, and if you don’t do well, you have a cut in payments.

So what’s a radiologist to do? The new payment models emphasize quality patient outcomes, so focus on quality, several speakers said. And establish good relationships with primary-care physicians. “They will be the gatekeepers for any kind of imaging,” Sweeney said. “Working with them is going to be important.”

Related seminar: The Business of Radiology

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