ACR is strongly urging Congress to adopt this front-end approach to utilization. "While the actual utilization of imaging equipment is going on, savings can still be obtained if policy encourages use of the right tools."

ACR is working arm-in-arm with the industry and other organizations to emphasize the decision-making aspect--the right tests for the right reasons. That would help alleviate the past and present problem of unnecessary imaging tests. Moran says ACR is getting encouraging signs that the Senate Finance Committee and even the House Committee are interested in considering these methods. "It would provide a much longer-term solution to the budget concerns that have arisen as to the utilization of imaging. It's an education and feedback program; if you have to penalize the physician for ordering the wrong test so be it. There are tools that can make it a seamless effort to ensure physicians are ordering the right tests," she says.


There are contradictions inherent in the imaging sector of the health care industry--new scientific developments are celebrated for exciting prospects in better diagnosis of cancer or Alzheimer's, balanced against the continual effort to cut the use or lower reimbursement of imaging. Moran agrees. "No one denies the use of imaging, particularly in being able in some cases to prevent surgery and hospitalization. There is every reason to encourage the use of diagnostic imaging. It's just unsustainable the way it has been going because it has been used inappropriately. If that breakdown in the system is addressed, it shouldn't be done by slash and burn cutting of the utilization rate." The approach needs to begin, Moran says, where the breakdown is--the decision process of whether the test should be ordered in the first place.

"If Congress doesn't address the issue the situation will be ongoing and get worse. The incentives are in the wrong place. If tools are mandated that can save imaging from being misused, you save money."

Read the proposal, "Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B (CY 2010), (2009-15835)," and go to page 59 for the section on equipment utilization:
www.federalregister.gov/inspection.aspx#special

Also read a report on rural health care in the July 2009 issue of DOTmed Business News.



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