Facility Management

Efforts by researchers and radiation safety advocates in the U.S. and abroad have led to the development of several techniques and strategies to reduce radiation dose from CT scanning.

Tens of millions of people eligible for colon cancer screening every year shy away from stool tests and the invasive colonoscopy exam. They could soon have another viable option: CT colonography.

Opposition to the Deficit Reduction Act cap on imaging reimbursements has inspired a grassroots coalition to conduct a political campaign in New York State uniting radiologists and patients against the Medicare rate cuts and other federal initiatives against medical imaging.

If the Deficit Reduction Act of 2005 wasn’t enough of a blow to the imaging industry this year, just wait. Congress has a surprise awaiting us in 2008.

Executives from GE Healthcare, Siemens Medical Solutions, and other imaging equipment vendors visited the White House last week to meet with presidential advisors about the effect of declining Medicare payments on the medical imaging industry.

The coming merger of Philips’ medical systems and home-care healthcare under its Vision 2010 initiative, announced Sept. 10, will allow cost savings through streamlined operations and increased revenues achieved by taking market share from competitors, according to Steve Rusckowski, the newly ordained leader of this soon-to-be-minted business unit.

As recently as last summer, industry pundits were predicting 10% growth in PET/CT sales, driven partly by expectations that the number of annual procedures would continue to grow by 20%. Then came the Deficit Reduction Act (DRA), and rulings by the Centers for Medicare and Medicaid Services that cut reimbursement in half for outpatient imaging centers.

The American College of Radiology has asked members for feedback on a draft of clinical performance measures involving several radiology subspecialty areas. The measures, designed to improve the quality of medical services, may be used to support pay-for-performance plans sponsored by the Centers for Medicare and Medicaid Services.

A battle to stop federal lawmakers from further restricting reimbursements for medical imaging is shaping up on Capitol Hill. The battleground is a provision built into the Children’s Health and Medicare Protection (CHAMP) Act of 2007.

Bob Bell has advice for the scores of freestanding MRI services that suddenly faced a possible loss of privately insured business when United Healthcare announced that it would limit reimbursement to sites that are accredited or seeking accreditation on March 1, 2008.

In the face of the changing dynamics of the PET/CT market, Hitachi Medical Systems America has decided to stop promoting its SceptreP3 product line.

A study by researchers from Boston and Brussels has found MR imaging more accurate than bone scintigraphy and x-rays for detection of bone metastases from prostate cancer. MRI could boost staging and management of these patients in a cost-effective way.

Free-standing imaging facilities have taken some hits lately. This is no secret to readers of Diagnostic Imaging, but they've not always been under such intense fire.

Imaging centers across the U.S. have cut back drastically on their purchase of big ticket products. Demand for 64-slice CTs and PET/CTs has plummeted in the wake of belt-tightening prompted by the Deficit Reduction Act. MR sales are sliding, as are those for ultrasound. RIS/PACS, however, is gaining ground, and much of its gain is coming in the outpatient arena.

The need for nighttime coverage relief was the initial driver of commercially viable teleradiology. For several years, however, the local in-house radiology group gained no economic value for outsourcing its nighttime work, because its members had to reread the cases the next day to formally convert the reports to primary reads. The group also had to pay a premium for nighttime services.

Vendors have employed a multitude of approaches to cut patient radiation dose by making data acquisition and analysis more efficient. Software has been developed to adjust dose to fit different body types and segments. Methods to factor in body weight, particularly when scanning children, have been considered. Step-and-shoot protocols have been devised to eliminate the overlap that comes from spiral scanning.

FDG-PET performed after two cycles of standard chemotherapy can accurately predict which patients with Hodgkin’s lymphoma will respond or relapse, according to a multicenter international study published in the Aug. 20 issue of the Journal of Clinical Oncology.

Over the past year, many payers and utilization management companies have been looking at accreditation and certification. Large payers, such as United Healthcare, Aetna, and Blue Shield (and soon Blue Cross), require the outpatient facility and its equipment to meet the American College of Radiology requirements at the risk of losing their contracts. These requirements can be demanding, as seen in the Blue Shield list for MRI or CT, according to Guidelines for Providers Performing Imaging Procedures: Blue Shield of California.

RadNet breaks into the black Fonar sells another Upright MRMerge Healthcare faces delistingVarian board member resigns

The American College of Radiology has redesigned its MR imaging accreditation program to address six clinical subspecialties served by the modality.

Deficit Reduction Act spurs PACSMerge delays 2Q resultsIMV report examines prostate cancer treatmentStereotaxis revenues rise, loss widens Acusphere loss narrows

Radiologists may not be in such hot demand as years past, but those who are working command larger salaries than ever. Physician recruiter Merritt, Hawkins & Associates found that demand for the new placement of radiologists has slipped more than 20% compared with 2006. On the brighter side, average and starting salaries rose, staffing incentives show an all-time high, and some radiology subspecialties are in high demand.

After absorbing the details contained in 924 pages, analysts are finding reasons for both optimism and caution regarding the proposed 2008 Physician Fee Schedule from the Centers for Medicare and Medicaid Services. Radiologists may immediately focus on its 9.9% rate reduction, but the mammoth document also lays out sweeping reforms covering the hot points of alleged kickback and self-referral abuses.

North American Scientific plans divestitureAlliance Imaging slips under federal axVolcano revenues rise, shares drop

The Children’s Health and Medicare Protection Act of 2007 may look like straightforward legislation to reauthorize a popular healthcare insurance program for poor children, but major reforms directed at medical imaging and the healthcare system as a whole are embedded in the bill passed by the House of Representatives Aug. 1.

Big-ticket items are suffering this year as reimbursement cuts resulting from the Deficit Reduction Act have had a wider and longer lasting effect than initially expected. Particularly hard hit has been PET/CT. The hybrid juggernaut had defied the odds for several years, marching forward with ever higher sales despite utilization rates at individual sites that allowed plenty of unused capacity.

Vendors of CT and MR equipment are taking it on the chin. A sales slump in the U.S., which began in the second half of 2006, has continued through the first half of 2007 on the heels of diminishing demand from imaging centers. The problem stems from reimbursement cuts brought about by the enactment this year of the federal government's Deficit Reduction Act and the chilling effect these cuts have had on purchases by outpatient facilities.

The Deficit Reduction Act of 2005 and the resulting decrease in Medicare's reimbursement schedule could result in as much as a 25% to 45% reduction in revenue for outpatient imaging practices, according to industry sources.1 Faced with such a potentially drastic scenario, many practice owners are reevaluating the very viability of their imaging operations.

Interventional radiology is growing rapidly as a subspeciality. The presence of a state-of-the-art interventional service within a radiology department will have a significant impact on that department's staffing, training, logistics, finances, and resources. Ongoing turf battles will also require substantial involvement from department heads.

Next month, a dazzling array of multidisciplinary academics will highlight promising prostate imaging techniques at a meeting in Washington, DC.