Medicare imaging savings
This article was originally published in The Gray Sheet
Executive Summary
Obama administration estimates that increasing the imaging equipment utilization factor used by CMS to calculate payments would save $2.5 billion over five years and $5.9 billion over 10 years in a "mid-session" 1review of the president's budget released last week. In June, as part of a plan to help pay for health reform, the administration floated the idea of changing the assumed equipment use rate from the current 50% to 95% of the time that imaging facilities are open, but did not quote specific savings figures (2"The Gray Sheet" June 22, 2009). Equipment manufacturers and radiologists have railed against the proposal, asserting that it would lead to significant underpayment for advanced imaging and harm rural clinics disproportionately. The mid-session review also shaves $10 million off the projected 10-year savings from implementation of a prior authorization requirement for Medicare-covered imaging scans - another proposal in Obama's health reform reserve fund (3"The Gray Sheet" March 2, 2009)