PET imaging chain could benefit from HCFA policy shift

If the Health Care Financing Administration (HCFA) shifts its emphasis to dedicated PET scanners, one of the winners could be Integral PET Associates. IPA has installed full-ring dedicated scanners, which could be the focus of HCFA’s broadened PET coverage (see cover story), at each of its eight centers.

“I think the decision (if finalized) would be very good for the patients with diseases that will be covered,” said Ron Lissak, president and CEO of Integral PET Associates. “I would see an increase in business.”

HCFA confirmed in early April that Medicare would cover six additional types of cancer as of July 1. But not all equipment capable of delivering positron-based images would be considered of equal clinical utility. IPA, however, is in a strong position to benefit.

In 1996, the New York City-based company installed its first dedicated PET system at Montefiore Medical Center in The Bronx, NY. Since then, IPA has installed PET systems at seven more centers in New York, New Jersey, Pennsylvania, and Washington, DC. About a dozen more are expected to be established this year, the company said.

“I never thought we’d own more than one,” Lissak said. “After the first was installed, we realized that we were greatly benefiting our patients. Our second project involved taking over the Georgetown University PET Center.”

Through the years, Integral has bought equipment exclusively from ADAC Laboratories. In all, IPA has purchased eight full-ring dedicated scanners from ADAC, which is now a part of Philips Medical Systems.

“I found that, for our environment and cost structure, dedicated PET systems worked very well,” Lissak said. “From a quality point of view, that’s the only kind of system we would use.”

The equipment supports all types of exams, including cardiac, brain, and oncologic scans, Lissak said. The centers where they are installed include a mix of outpatient, hospital-based, and academic programs. Some specialize in providing specific services; Georgetown does a high volume of breast exams, while Montefiore specializes in head and neck scans.

In all, the eight centers complete 25 to 30 imaging exams per day. Most procedures are covered by Medicare or another third-party payer. Referrals have been coming mostly from oncologists and pulmonologists, Lissak said.

“We’re spending a lot of our energy educating physicians,” he said. “At this point, many physicians truly don’t understand the benefits of PET.”

To meet that challenge, IPA has established a Web presence and hired a public relations representative to get the word out to communities surrounding the individual centers. Additionally, staff at the centers meet regularly with physicians.

Receiving special attention in the near future will be fusion imaging. Lissak plans to use PET in conjunction with CT and radiation therapy in hopes of boosting PET’s clinical utility and its appeal to referring physicians. Lissak also plans to expand the number of sites in IPA’s growing community of centers.

“We’re looking to expand our coverage,” he said. “By the end of the year we hope to have close to 20 sites.”

The impact of HCFA policy-making is not certain, nor are the effects of an apparent downturn in the U.S. economy. Key to continued growth in demand for PET imaging is an understanding by referring physicians of the value this modality has for patients.

“Once physicians understand the benefits of this procedure and that it’s cost-justified, they won’t be able to say no to the test,” Lissak said.