Managers of radiology departments and imaging centers are hoping for a strong finish to 2018, based on data and comments in the fourth quarter of the Medical Imaging Confidence Index (MICI). Still, nagging questions remain about reimbursement from Medicare and private payors.
The composite index score for the fourth quarter of 2018 was 111, which MICI classifies as expressing "high confidence." That compares to a composite score of 109 in the third-quarter index, a difference that isn't statistically significant. The composite score for the fourth quarter of 2017 was 110.
The Medical Imaging Confidence Index is derived from survey responses of imaging directors and hospital managers who are members of the AHRA, the association for medical imaging management. Market research firm the MarkeTech Group surveys members of the MICI panel about five important trends faced by radiology administrators and business managers in the upcoming quarter to provide a barometer of their sentiment about near-term business prospects.
For the 2018 fourth-quarter data, MICI surveyed 150 participants from across the U.S., with 13% based in the Mid-Atlantic region, 14% in the South Atlantic region, 5% in the East South Central region, 21% in the East North Central region, 19% in the West North Central region, 12% in the West South Central region, 5% in the Mountain region, and 11% in the Pacific region.
Participants were asked to rate their optimism about five topics, and a single composite score including all five categories was also calculated. Scores ranged from 0 to 200 and can be interpreted as follows:
- < 50 = extremely low confidence
- 50 to 69 = very low confidence
- 70 to 89 = low confidence
- 90 to 110 = an ambivalent score (neutral)
- 111 to 130 = high confidence
- 131 to 150 = very high confidence
- > 150 = extremely high confidence
For the Q4 2018 survey, respondents were most confident that their facility will maintain or grow as a profit center, with a score of 132. Administrators also showed optimism that their internal operating and staff costs would remain constant, with a mean score of 131, followed by confidence in their facility's ability to grow monthly in diagnostic and interventional radiology, with a score of 124.
| MICI scores by topic for Q4 2018 | ||
| Topic | Mean score | Interpretation |
| Will maintain/grow as a profit center | 132 | Very high confidence |
| Internal operating and staff costs will remain constant | 131 | Very high confidence |
| Will grow monthly in diagnostic and interventional radiology | 124 | High confidence |
| Composite score across all areas | 111 | High confidence |
| Will have access to capital for imaging equipment and IT needs | 97 | Neutral |
| Will receive adequate reimbursement from Medicare for diagnostic and interventional imaging | 79 | Low confidence |
MICI scores for the fourth quarter of 2018 and their relationship to the previous eight quarters are shown in the following chart.
As in past surveys, radiology administrators expressed the lowest level of confidence in getting adequate reimbursement from Medicare, with a score of 79. Administrators were more optimistic in their outlook for accessing capital for imaging equipment and IT needs, with a score of 97, which is classified as "neutral."
In the qualitative section of the survey, some members of the MICI panel expressed optimism as the year draws to a close, with procedure volume growing in areas such as interventional radiology and cardiac imaging. The start of a new fiscal year has seen the release of capital funds for equipment replacement and upgrades.
On the other hand, reimbursement continues to be a constant worry.
"I think the reduction in reimbursements is hurting imaging departments and will continue if Medicaid and Medicare continue to cut further into reimbursements," one MICI respondent said.
