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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.

Radiologists could be shortchanged if Medicare goes through with plans announced Monday to end its long-standing policy of paying separately for imaging contrast media, radiopharmaceuticals, interventional radiology supervision, and interpretation.

As imaging centers across the country fall behind on equipment payments, they are getting calls from workout groups. We’re not talking gym memberships here. These groups try to recoup lost revenues from notes in default and are being used more than ever in the radiology finance world. During the past few months, I have spent a good portion of my time speaking to finance vendors involved in attempting to salvage centers. It is frightening to see the washout of once-profitable centers, as they fall victim to the draconian cuts in Medicare reimbursement resulting from the Deficit Reduction Act.

Despite heated interest in cardiac CT, echocardiography continues to anchor the diagnosis and evaluation of coronary artery disease for most clinical practices. Echo possesses prognostic as well as diagnostic power, as demonstrated in a large Weill Cornell Medical College study. It found strong correlations between wall motion abnormalities detected during echocardiography and risk for cardiovascular death. On the cardiac CT front, more research investigating its clinical utility and radiation exposure was reported.

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Philips Medical slips on DRA impactRefurbisher inks agreement to distribute radiotherapy equipment

Blue Cross Blue Shield of Michigan and Blue Care Network are partnering with Michigan hospitals to examine whether coronary CT angiography, under certain circumstances, can be used as a complement or replacement for cardiac catheterization.

The Centers for Medicare and Medicaid Services has initiated a national coverage analysis to evaluate the available evidence for coronary CT angiography. As part of the effort, the agency on June 13 asked practitioners to submit comments. If the remarks so far are any indication -- and if CMS listens -- coronary CTA will have no problem securing Medicare reimbursement.

Acting in their capacity as medicine's designated custodians for issues involving ionizing radiation, radiologists defined strategies this year to address the dangers accompanying the explosive growth in the number of medical procedures that require ionizing radiation.

After scoring high marks in a new cost-effectiveness study, virtual colonoscopy is poised to crawl out of clinical obscurity and boost colorectal screening rates.

Historically, the federal government has taken the lead in pursuing fraud claims against healthcare providers. Section 6031 of the recently enacted Deficit Reduction Act of 2005 (DRA), which provides a financial incentive for states to enact their own false claims legislation, is changing that.

Business briefs

iCAD pairs with Agfa for mammography systemSonoSite extends availability of algorithmAurora offers breast MR insurance supportContextVision lands OEM contractsAmicas picks up major IT contract

A suite of teleradiology products and services launched at the SIIM meeting will improve efficiency by intelligently routing studies, according to its developer, CoActiv Medical. The suite, called Exam-Net, focuses on image distribution, reading, and archiving. Its Acquire & Forward Server receives studies directly from multiple modalities or an existing PACS, automatically sending them for temporary storage to a hosted Exam-Net server at one of CoActiv's data centers, or to an onsite imaging location. The hosted server can be programmed for "intelligent" imaging forwarding, automatically routing studies to appropriate radiologists at any location.

Siemens Medical Solutions put its syngo Suite in the spotlight at SIIM 2007 as the means to an advanced level of interoperability and flexibility for imaging centers. The product, a hybrid IT that integrates RIS, PACS, postprocessing, and patient data handling, brings image management and practice management together in an easy-to-use package.

Last year, the Society for Imaging Informatics in Medicine attracted 24 essays from residents and other trainees vying to win travel reimbursement to the meeting. This year, the society received no essays, according to Dr. Barton F. Branstetter IV, chair of the SIIM education committee, who moderated a morning resident roundtable session.

The elderly patient was a major donor to the hospital. Intraoperative ultrasound revealed an unexpected liver lesion. Color Doppler showed vascularity. If the lesion was a cancerous tumor, the entire liver would need to be removed, the surgeon told radiologist Dr. Stephen Horii. Only histology would reveal actual pathology.