by Loren Bonner
, DOTmed News Online Editor | December 09, 2013
Last week at the Radiological Society of North America's annual meeting in Chicago, DOTmed News caught up with Dave Fisher, vice president of health care policy and strategy at Siemens Healthcare. He shared his thoughts on the myriad issues imaging is facing as they relate to policy — not just health care reform, but also the medical device excise tax and the unique device identifier rule. Below is an edited version of our conversation.
DMN: Health care reform seems to be creating a huge consolidation of hospitals. How does this, in turn, affect Siemens as vendor of capital equipment?
Consolidation is a fact in the industry, and there are a lot of reasons for it. One of the obvious reasons is that as organizations become larger, they are often able to find efficiencies that they were not able to otherwise. For a vendor like us that creates challenges: When you have a larger organization, oftentimes centralized decision-making for things like capital equipment is implemented — not always, but often. When you have centralized decision-making, you're talking to a different group of people. In addition, larger organizations can often have different priorities for the purchase of capital equipment. Perhaps as we strive for efficiency we tend to purchase certain types of equipment than other ones. So all of these things are important. And of course when you have a large customer, they have an additional level of market power, which is important in terms of our negotiations with them.
DMN: What other challenges does imaging face under health care reform?
When you are looking at the next couple of years, there are at least two areas that we are particularly interested in. First, how accurate were the projections of the number of people who will be newly covered and what sort of impact will that have on health care spending over the next 2-5 years? Challenges that have been associated with the law whether it's the Medicaid expansion or now with the difficulty of sign-up — all could have implications, longer-term, on the number of people that are in the system and then, just by default, the cost for health insurance. But it's also too early to tell. The other area is payment reform and there are many elements within that law that are nudging the system toward a more fee-for-value oriented health care system. I think it's more incremental than transformative at this point, but these increments are going to keep happening. And we have to think about the health care system in a different way, and our customers in a different way when imaging and diagnostics are costs in the system. It's a different way of thinking.