Private radiology practices think globally, act locally on imaging payment cuts

Scores of radiologists from private imaging centers in the New York City metro area and thousands of their patients have organized to pressure their representatives in Congress for support in preserving access to imaging services. Their approach targets key players dealing with health care reform.

“We have access to legislators who are much more in tune with (healthcare reform) as opposed to other campaigns that may not have direct access to the lawmakers who have a say in national policy,” said Dr. Pradeep Albert, cofounder of the ‘Emergency Coalition to Save Cancer Imaging.’

The coalition includes physicians and patients from 14 private radiology groups from the New York City metro area. According to Albert, who is also a radiologist and partner at Medical Arts Radiology, a group of 15 radiologists in Long Island, the coalition includes to date about 200 to 250 physicians and thousands of patients.

Outpatient imaging facilities bore the brunt of the reimbursement cuts mandated by the Federal Deficit Reduction Act of 2005 and many went out of business. A new proposal by the Centers for Medicare and Medicaid Services could mean further reductions of up to 40% in reimbursement for the technical component of imaging services, said coalition co-founder Dr. Eric Schnipper, owner and political director at Long Island’s Nassau Radiologic Group.

The CMS proposal to raise the equipment weekly utilization assumption rate from 50% to 90% has been adopted by House and the Senate in their respective health care reform bills. In the House the rate is proposed at 75%. The Senate adopted the CMS plan. The cuts, aimed at equipment valued at more than $1 million, would affect much more than cancer imaging, Schnipper acknowledged. Abdominal, neurological, orthopedic services and others would be affected as well.

The coalition focused on cancer imaging because members believe that the greatest impact on care would be a delay in diagnosis for cancer patients, Schnipper told Diagnostic Imaging. For several years New York-area imaging centers have been able to subsidize mammography screening because of the payments for MRI, CT, and PET. The higher utilization rates for this type of equipment will reduce their profitability and their ability to subsidize services like mammography, Schnipper said.

“Patients with appendicitis or diverticulitis of course will have a hard time finding a CT scan available. But in terms of the numbers of patients affected, nothing would be worse than cancer.”

There are data to support the Coalition’s concerns, Schnipper said. Since 1999, 26% of all mammography practices in the New York City area have gone out of business or have stopped providing mammography. Patient wait times have increased by 171%, he said.

In mid August, the coalition ( www.savecancerimaging.org ) delivered a petition signed by more than 5000 patients to the offices of Health and Human Services Secretary Kathleen Sebelius, U.S. Senator Charles Schumer (D-NY), U.S. Senator Kirsten Gillibrand (D-NY) and Rep. Charles Rangel (D-NY). All are members of Congressional health panels. In total, they have petitions signed by nearly 13,000 patients.

“Other imaging advocacy groups take on very diverse things. They want to save the world of imaging, they want to do everything,” Albert said. “We are very focused. Our goal is to stop the utilization factor increase.”

Coalition members hope they will be able to make members of Congress and patients aware of what is at stake, Schnipper said.

“That’s our biggest challenge. It’s to be heard in that large forum with so many different players,” he said.