Physician Self-Referrals Can Hurt Radiology

Published on the Aug. 11, 2011, DiagnosticImaging.com Web site

By Whitney L.J. Howell

Cuts to reimbursement payments are looming thanks to health care reform measures. No doubt, they have you and other specialty providers scrambling to identify strategies to compensate for the lost revenue.

For some physicians — those who either own or have a vested financial interest in imaging equipment — self-referring patients could be a convenient way to off-set any drops in reimbursement. But, according to one radiologist, the practice should be stopped because it hurts radiologists in other health care settings.

“Physician-owned imaging equipment diverts dwindling health care resources especially away from non-profit hospitals that still scan the poor and indigent but no longer get the revenue from the insured patients,” said Sidney Roberts, M.D., president of the Texas Radiological Society and radiation oncologist at the Arthur Temple, Sr. Regional Cancer Center. “This drives up the cost of care for everyone.”

Some in health care support self-referral both as a convenience for patients and as a way to pre-authorize more imaging studies. It’s a false argument, though, Roberts said. Diagnostic imaging studies are rarely conducted the day they’re ordered, and there is no guarantee the location to which a patient is referred will be more easily accessible on another day than a hospital or imaging center.

Curtailing physicians’ ability to self-refer for imaging studies will require national buy-in, he said.
“Self-referral needs to be addressed on a national level rather than individual states enacting legislation in a piecemeal way,” he said. “The federal government has a role to play in banning the practice.”

To read the story on the original Web site: http://www.diagnosticimaging.com/practice-management/content/article/113619/1926298?CID=rss&cid=dlvr.it

What Health Reform Means for Radiologists

Published on the Aug. 11, 2011, DiagnosticImaging.com Web site

By Whitney L.J. Howell

The health care system as you’ve known it will look drastically different within the next few years, and the radiology industry is set to change with it. If you want to stay afloat and have a competitive practice, you must know which parts of the health reform legislation will affect you and how to handle them.

That’s the message from Robert Still, MD, practice manager for Lancaster Radiology Associates Ltd. in Auburn, Pa. Speaking at the AHRA: The Association for Medical Imaging Management annual meeting in Dallas next week, Still says accountability will be the most important thing to remember as health reform legislation comes online.

“The ways we measure quality in health care and radiology will change. The focus will be higher quality at lower cost,” he said. “As accountable care organizations are introduced, all payments will be bundled and reimbursements will be value based.”

This bundling means you will no longer be reimbursed separately for your services. Instead, your payments will be part of a larger one that includes facility, technical, and physician charges. It could also mean you start assuming a more consultative role in patient care, offering input and making recommendations about which imaging studies are most appropriate, Still said.

This change has industry leaders concerned. They fear policymakers are following MedPAC’s lead in considering bundles or cuts to all the payment codes you use.

“There will be a huge impact in reimbursement if every code is up for grabs,” said Maurine Dennis, senior director of economics and health policy at the American College of Radiology. “Diagnostic radiology is behind the 8-ball and is feeling the biggest impact from reform.”

To read the entire story: http://www.diagnosticimaging.com/healthcare_reform/content/article/113619/1926311?CID=rss&cid=dlvr.it