The Medical Imaging and Technology Alliance (MITA) approves of the 2014 hospital outpatient prospective payment system (HOPPS) final rule issued by the U.S. Centers for Medicare and Medicaid Services (CMS).
The alliance also approves of a study appearing in the December American Journal of Roentgenology (AJR, Vol. 201:6, pp. 1277-1282) declaring medical imaging is not the cost driver of Medicare.
In terms of the CMS final rule, MITA said the rule improves on the program's earlier proposal by including a transition to more accurately account for costs associated with CT and MR services. At the same time, MITA said this new policy still includes inaccurate cost data that will lead to inaccurate reimbursements for advanced medical imaging services in the hospital outpatient setting.
MITA also applauded changes in the 2014 physician fee schedule (PFS) final rule, which should help avoid new barriers to access to radiation therapy, ultrasound, echocardiography, and other services outside a hospital setting.
Hopefully, the four-year transition period will help hospitals incorporate the necessary changes to ensure only valid data are used to determine payments, MITA said.
"Moving forward, it is critical that reimbursement reflects the full value and operational cost of each technology and that patient access to lifesaving imaging is preserved," the alliance added.
CMS also rejected a PFS proposal that would have capped payments for more than 200 codes within the physician fee schedule at the 2013 hospital payment level for services such as chemotherapy administration, diagnostic imaging, radiation therapy, and pathology, a decision MITA approves of .
In other MITA news, the alliance has lauded an AJR study because it confirms what physicians, researchers, and device manufacturers have long known regarding the steady slowdown of Medicare expenditures for medical imaging.
The study authors analyzed Medicare claims data to determine that spending growth on diagnostic imaging was in the 80th percentile of all Medicare services in 2001. However, by 2011, spending on diagnostic imaging drastically slowed to the point where it now resides only in the second growth percentile. The study also notes that from 2006 to 2011, spending for nonimaging services grew by 3.6% versus a 3.5% decline for imaging.
The study shows not only has expenditure growth dramatically slowed for medical imaging, but other healthcare services have far surpassed it as Medicare cost drivers, MITA said.
"This new data is critical as policymakers look for cost efficiencies within the Medicare program that continue to deliver value to patients and improve outcomes," the alliance added. "Medical imaging, resting near the bottom in Medicare growth expenditures, has advanced the practice of medicine by providing the ability for earlier diagnoses, reducing the need for exploratory surgeries and increasing accuracy in the course of treatment."
