Radiology doesn’t escape far reach of healthcare reform legislation

Healthcare reform legislation signed into law last month by President Obama promises to bring sweeping changes to the healthcare system, potentially including the practice of radiology.

Signed into law were the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. Together, they seek to expand access to health insurance (through subsidies, mandates, and market reforms), reduce healthcare spending (primarily through cuts to providers in the Medicare program, including payments for diagnostic imaging services), and institute a variety of other health policy reforms. Beyond that, they portend major transformative change to the healthcare delivery system in the years to come.

For radiologists and other imaging providers, several actions will have a direct and immediate impact.

Cuts to diagnostic imaging payments
It is no surprise that diagnostic imaging has been a target for more than its share of the cuts. The strategy to cut spending for imaging services has been to decrease payments for the technical component of certain nonhospital advanced imaging services. Historically, CMS assumed that imaging equipment was used 25 hours per week (50% of the time) in applying practice expense relative value scale (RVS) values to payments for imaging services. If this utilization factor were to be increased, the cost of the equipment (and thus the payments) would spread over more units of service, thus lowering the payments per procedure.

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