From the May 2011 issue of HealthCare Business News magazine

Practices that weren’t reimbursed at a level that covered their operating cost have phased-out their DXA services, discontinued their system contracts and laid off their X-ray techs, all of which has put manufacturers on the alert.

Impact on DXA sales
Laura Stoltenberg, general manager of the Lunar division of GE Healthcare, has seen signs of a downward trend for some physician practices.
“We have talked with various clinical groups and the concern with any changes in guidelines and reimbursement rates and the potential impact on what that does to clinical access to the equipment,” says Stoltenberg.

The impact of reimbursement cuts, according to Stoltenberg, had been an overall decline in the purchases or even a decrease in the return of leased equipment.

John Jenkins, vice president and general manager of skeletal health for Hologic, has also seen DXA sales from physician practices slow down, but says there was a time when physicians sought to provide more on-site services.

“Physicians were very interested in providing point-of-care assessment for osteoporosis, but what happened was that we saw our physician sales decline and our hospital sales actually get reinvigorated, because most of the systems at the hospital were end-of-life systems that were nearly 10 years old.”

Curtailed rural access
With services being cut back in private and group physician practices, more business is going to hospitals, which have not suffered the same reimbursement cuts as non-hospital settings. The increased business for hospitals is great news, except when you factor in the loss of local access for osteoporosis patients living in rural areas.

“Studies have shown that if patients have a drive of more than five to 10 miles from services, those services may not get [used],” says Laster. “Given the setting, where already an inadequate number of people are getting tested, if you restrict it further and make access less available, then you’ll have a hard time meeting the goals to increase screening to identify people at risk.”

Will new recommendations be enough?
The two-year lift on Medicare cuts for bone density testing will be reviewed again and further legislation will have to be enacted to continue the current level of reimbursement.

“If there isn’t further relief with new legislation, then the reimbursement would drop again to $47 in 2012 and $42 in 2013 in the non-hospital setting,” says Laster.

Even if new legislation keeps a larger slice of reimbursement, Siris says there are still glitches in filing Medicare claims. Physicians currently have approval to screen at-risk women at two-year intervals, but there is some difficulty getting the tests reimbursed. Medicare claims do get paid, but physicians have to jump through hoops.

May 2011 Magazine

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