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Health care's failure isn't in the technology

by Sean Ruck, Contributing Editor | July 01, 2014
From the July 2014 issue of HealthCare Business News magazine

While we were putting together this issue, a point popped up that I've talked about before, but I don't think it's ever been so blatant. In the feature piece on breast tomosynthesis (p. 46) and in the industry sector report on bone densitometers (p. 56) , a main topic of discussion is reimbursement, or lack thereof. Obviously reimbursement cuts are discussed and grumbled about in nearly every sector of health care, but in the case of those two procedures, the pain of reimbursement issues is more acute.

For bone densitometry, the cuts to reimbursement over the years have essentially crippled health care providers' ability to offer the exam. From being a modestly profitable service, to a break-even to where it is now for many - a money losing proposition, the situation has devolved to the point that there is an underserved patient base and I predict that this lapse in providing preventative screening will ultimately cost more than the savings delivered by the reimbursement cuts. While there are organizations attempting to call attention to this shortcoming, the situation looks decidedly grim.

Meanwhile, for digital breast tomosynthesis, it seems proponents of the technology are finally getting some good news. Coding for reimbursement is scheduled to be published in November of this year and the reimbursement rates will be released in January of 2015. One can assume with reimbursement backing that the technology, which has enjoyed a strong adoption rate since the first unit received 510(k) clearance in the beginning of 2011, will be adopted by more health care providers.

But the stories behind both technologies should raise questions. For one, there's a screening procedure that could help to improve the quality of life for a large portion of the U.S. which has a significant percentage of elderly citizens. For the other, we have a technology that can improve outcomes by catching breast cancer at an earlier and more readily treatable stage. But reimbursement has been taken away from one to the point of making it an untenable offering for many facilities and reimbursement was markedly slow to kick-in for the other. In my mind, these are just two more instances where our health care focus fails - we're not supporting preventative health care. So what we are instead supporting is a health care model where we treat the disease(s). It's a mystery to me that we're still conducting business as usual in that regard. Just to use an analogy - if you had the choice to have your home inspected and a professional could point out hazards you could address to prevent a fire or you had a really experienced fire department that could contain a fire before your house was a total loss, which would you pick?

Before I wrap up this month's letter, I want to express my appreciation to Loren Bonner. Loren has moved on from DOTmed, but she will be missed. We all wish her the best.

Until next issue!

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