You are here: Value of Medical Imaging

  • 09.20.12

    Cancer Survivors and Other Patient Advocates Call on Congress to Preserve Access to Medical Imaging and Radiation Therapy Technologies

    New Data Confirms Continued Decline in Use of Medical Imaging and Spending in Medicare 

    Washington, DC – Today, the Access to Medical Imaging Coalition (AMIC) submitted a letter to Congress signed by 22 leading patient advocacy organizations urging them to protect advanced medical imaging and radiation therapy services against further reimbursement cuts and radiology benefit manager (RBM) and prior authorization proposals that would limit patient access to care. With eight cuts to medical imaging reimbursements in the past six years, the letter was unveiled during a press conference on Capitol Hill in anticipation that these threatening proposals will be introduced again this fall.

    “Patients cannot afford to lose access to these life-saving technologies that detect, diagnose and treat cancers and other diseases,” said Erika Hanson Brown, cancer survivor and founder of COLONTOWN, a letter signatory. “We urge Congress to consider the tremendous role that medical imaging and radiation therapy have played in the lives of countless patients who our advocacy organizations represent when they contemplate additional Medicare cuts to imaging as well as using prior authorization schemes in Medicare that will create additional barriers for patients seeking imaging.”

    At the press conference, AMIC also warned that new data indicates patients are receiving fewer imaging procedures for the second year in a row. The new analysis from the Medical Imaging & Technology Alliance (MITA) found:

    • Imaging utilization per Medicare beneficiary declined by 5.12 percent since 2009
    • Spending on imaging services for each Medicare beneficiary has dropped 16.7 percent since 2006
    • Medicare spending on non-imaging services has grown 21.3 percent since 2006.

    “The fact that data continues to show that imaging utilization and spending are on the decline raises serious concerns about whether patients are receiving the care they need,” said Tim Trysla, Executive Director of AMIC. “Medicare cuts to imaging have rippled through diseases limiting patients’ access to early detection, which saves lives.  From PET scans to breast MRI to CT screening for lung cancer, reimbursements have been cut eight times in six years.  Further reimbursement cuts for imaging services or the implementation of a prior authorization program would only create additional, unnecessary barriers for patients in need of care.”

    In the letter to Congress, the patient advocacy organizations note that by impeding access to needed imaging services and undercutting the benefits of early detection, subsequent cuts to Medicare reimbursement will actually result in greater long-term healthcare spending. Similarly, the use of a prior authorization program has been shown to significantly delay and even deny services to patients without yielding any significant cost savings for taxpayers over the long-term. An in-depth report by the Patient Advocate Foundation (PAF) examining 4,360 patient cases involving barriers to imaging access from 2007 to 2011 found that 81 percent of the insurance denials for imaging procedures were due to prior authorization programs, stating reasons ranging from “not medically necessary” to “benefit exclusion” to “necessary prior authorization needed to be obtained, according to a May 9, 2012 POLITICO op-ed by Nancy Davenport-Ennis, PAF’s Founder and Chief Executive Officer.

    Rather than continuing to layer on draconian reimbursement cuts for imaging and radiation therapy services or imposing costly administrative barriers to care, AMIC urges Congress to support the widespread adoption of evidence-based, physician-developed imaging appropriateness criteria in conjunction with decision support tools to educate physicians. Adoption of established appropriateness criteria and clinical decision support will ensure that the decision to order a test remains in the physician’s hands, rather than a third party who does not have the patient’s best interests in mind.

    Groups that signed onto the letter include: AMIC, American Liver Foundation, American Urological Association, Black Women’s Health Imperative, Bladder Cancer Advocacy Network, Chris4Life, Coalition for Pulmonary Fibrosis, Colon Cancer Alliance, COLONTOWN, Fight Colorectal Cancer, Gilda’s Club of Western PA, Hypertrophic Cardiomyopathy Association, Kidney Cancer Association, Lung Cancer Alliance, National Marfan Foundation, National Rural Health Association, Prevent Cancer Foundation, Society for Women’s Health Research, The Leukemia & Lymphoma Society, Us TOO International, YES! Beat Liver Tumors, and ZERO The Project to End Prostate Cancer.

    AMIC has a long history of working to protect patients’ access to life-saving diagnostic and preventive imaging services and radiation therapy. This week, AMIC hosted the Right Scan Right Time Advocacy Academy to inform and educate passionate patient advocates about how to effectively engage their members of Congress in meaningful and impactful ways.

    ###

    The Access to Medical Imaging Coalition represents physicians, medical providers, and patient organizations throughout the U.S. It also includes health technology firms that manufacture imaging equipment and supplies and that employ tens of thousands of workers. Thus, AMIC represents those who develop medical imaging technologies, those who apply it, and those who benefit from it.

Connect with Us Online

  • Twitter
  • Facebook
  • YouTube
  • Flickr