Facility Management

White House officials urged Republican senators Friday to reverse their support of a Senate bill that would set aside an impending 10.6% physician payment cut from Medicare, allowing President Bush to veto the legislation.

The Senate passed key legislation July 9 that forestalls a 10.6% cut in Medicare physician payments following intense lobbying from patient and physician advocacy groups over the Independence Day Congressional recess. The 69-30 tally in favor of the bill makes it veto-proof.

Pending clinical trial results played a pivotal role in the Centers for Medicare and Medicaid Services' decision in March to set aside plans to establish a national payment policy for outpatient multislice coronary CT angiography. Other published trials advanced our understanding of how nuclear cardiology, echocardiography, and cardiac MRI fit in evolving diagnostic practice.

Now that computer-aided detection has become part of routine clinical work for cancer screening in mammograms and is being applied in the differential diagnosis of cancer in the lung and colon, it's only a matter of time before it rates as the standard of care for diagnostic examinations in daily clinical work.

Showing CT colonography's value for cancer screening was one thing. Proving it could handle the volume of patients who may need the test in years to come, however, is an entirely different task. Researchers say not to fret.

A system presented at the SIIM meeting is able to develop work lists based on a patient's insurance and a radiologist's credentialing status, which are important considerations as more studies are interpreted away from central offices and facilities try to maximize reimbursement.

Screening ultrasound paired with mammography improved breast cancer detection in high-risk women, but the combination also caused a spike in the number of false positives, according to an update to the American College of Radiology Imaging Network 6666 trial. These results may render ultrasound less attractive than MRI in this patient population.

The patient who reported for a CT scan at the Spring Valley imaging center in Las Vegas complained of headaches, but the images returned by the newly installed AquilionOne CT scanner indicated something much worse was probably on the way. Neuroradiologist Dr. William Orrison defined a major region of hypoperfusion in the brain, a warning sign that the patient was at risk of stroke.

The first six months of 2008 demonstrated the connectivity of diagnostic imaging.

Several radiology-related professional societies have joined forces to urge the Centers for Medicare and Medicaid Services to approve national Medicare coverage for CT colonography to screen patients for colorectal cancer.

Society of Nuclear Medicine officials say the Centers for Medicare and Medicaid Services is manipulating the definition of radiopharmaceuticals to artificially deflate its payment rates for radioactive imaging agents essential to nuclear and molecular imaging practice.

The launch of the experimental Japanese WINDS satellite in late February holds promise for teleradiology, with researchers hoping the geostationary Ka-band communications satellite will boost teleradiology into a new ultrahigh-speed communications era.

The U.S. Senate fell six votes short Thursday, June 12, of achieving the 60 votes needed to block debate on legislation that would have set aside an impending 10.6% cut in Medicare physician payments.

Interventional radiologists, like their diagnostic counterparts, remain under pressure as payers ratchet back reimbursements. But they continue to fight on the reimbursement front and see some silver linings in new government programs designed to improve the quality of care.

Contrast-enhanced ultrasound for abdominal applications in radiology was first approved in Canada in 2001. Although reimbursement issues have prevented its general dissemination and adoption, ample publications describe the benefits and applications of this exciting and robust technique.

New models and upgrades for high-field systems continue to shape 2008 in lingering buyer's market After three years of declining sales, manufacturers are hoping for a rebound in the MR marketplace this year. If it comes, it won't be much.

When it comes to getting respect, radiologists are apparently the Rodney Dangerfield of the medical profession.

Dr. James H. Thrall, radiologist-in-chief at Massachusetts General Hospital, has been chosen as the new chair of the American College of Radiology Board of Chancellors. He was appointed during the college’s 2008 annual meeting in Washington, DC.

The Centers for Medicare and Medicaid Services is now accepting public comments on national coverage for CT colonography. Comments will be accepted through June 18, 2008, at the CMS web site.

Jericho Specialty Imaging, an imaging facility based in New Hyde Park, NY, has filed an antitrust complaint against CareCore National, a radiology management service company that contracts with major health maintenance organizations.

A system presented at the SIIM meeting is able to develop work lists based on a patient’s insurance and a radiologist’s credentialing status, important considerations as more and more studies are interpreted away from central offices and facilities try to maximize reimbursement.

Logistical and reimbursement limitations dictate that most CT exams be performed on an outpatient basis, making it difficult to manage contrast-related reactions, especially in patients with renal insufficiency. Oral hydration may be as effective as intravenous fluids for preventing contrast-induced nephropathy in some instances, but further study is needed.

Researchers in San Francisco have found that MR imaging can accurately predict recurrence and development of metastatic disease in patients who are about to undergo radiation therapy for prostate cancer. Study findings suggest a stronger role for MRI in the management of the condition.

It's not too early to look ahead to 2009 and beyond, at least not during an election year in which healthcare financing reform is a major issue.

>Declining reimbursements in outpatient diagnostic imaging pose significant challenges for center operators across the county. What was once a fairly easy business to operate has in many ways become a challenge, especially during the past two years. Finding a good technologist was, and still is to a certain extent, a hardship for some radiology departments, but hiring a skilled manager is proving to be like finding a needle in a haystack.