So, What’s the Damage?

Ms. PACS: We might finally get the bill. I’m talking about the latest proposed healthcare reform bill from Congress - this one hovers around $856 billion.

Many said the proposal still spends too much, and it does too little to cut healthcare costs. But the final details were etched out by a bipartisan group of senators so that in the end – we’re all to blame.

This latest proposition in healthcare reform does not provide for a ‘public option,’ but would require everyone in the U.S. to purchase health insurance by 2013. So what are the option for diagnostic imaging?

For starters, the bill would levy $4 billion in annual fees on medical-device manufacturers beginning in 2010. Fees would be proportioned according to each company’s market share. Some say the government believes device makers will actually benefit from an overhaul thanks to wider insurance coverage, which will bring them more customers. So, it’s sort of like paying insurance to the White House to help pay for the package.

What a more widely insured population will do is grow the volume of diagnostic imaging exams. But at what cost?

As government scrambles to cut healthcare costs, it repeatedly targets medical imaging reimbursement. Fortunately, there is some reprieve – this version of the healthcare reform bill would set the equipment utilization rate for Medicare reimbursement of imaging studies at 65 percent, significantly lower than the 90 percent level proposed in original versions of the legislation.

If this passes, it will be a relief to radiology and radiation oncology alike. In the recent Medicare physician fee schedule proposed rule, Medicare payment rates for physician services, including radiation oncology, proposed cutting radiation therapy services by nearly 20 percent.

As we all know, what is at stake is the sustainability of freestanding and community-based cancer centers, as many would be forced to close, stop accepting Medicare patients and reduce critical services to cancer patients. Obviously not a healthy prescription for anybody.

So, PACS people, how does this relate to you - but, really, you should ask, how doesn't it? One of the best healthcare plans, albeit unofficial, to surface in the ‘media’ thus far comes from a concerned radiation oncologist who got it posted on another popular PACS blog - the Daili PACS Blog. Not surprisingly, he suggests scrapping most of HR 3200 proposals.