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  • 11.28.12

    New AMIC Survey Data Shows 2010 Medicare Payment Cuts Forcing Physician Practices and Imaging Providers to Reduce Patient-Centered Jobs and Forgo Technology Upgrades

    Increased Use of RBMs by Private Payers Forcing Physician Practices to Increase Administrative Staff

    Washington, D.C. – The Access to Medical Imaging Coalition (AMIC) today released a nationwide survey of 131 physician practices and imaging providers finding that practices and providers are being forced to scale back on staff and technology upgrades to adjust to the reduced Medicare payment environment.

    “It’s no surprise that relentless cuts to medical imaging are having an adverse impact on physician practices and imaging providers and their ability to effectively serve patients,” said Tim Trysla, Executive Director of AMIC.  “Most worrisome are additional proposed cuts that will compound the access barriers that seniors face today.  Reducing access to early detection makes no sense as it will impair health outcomes and drive up costs over the long-term.”

    With nearly 9 out of ten physician practices and imaging providers reporting a negative financial impact due to the payment cuts, 42 percent of practices said they were forced to reduce staff, while more than 24 percent of physician practices and imaging providers reported that they had to forego medical imaging technology upgrades.

    The AMIC survey also revealed that while Medicare imaging cuts contributed to a reduction in staff that treat patients, physician practices and imaging providers are also facing growing administrative staffing pressures as a result of the increased use of Radiology Benefit Managers (RBMs) by private payers for pre- and prior authorization for imaging services.  More than 43 percent of practices and providers reported having to hire more administrative staff to juggle the additional bureaucratic strain posed by the use of RBMs.

    In the past, the Obama Administration has proposed using RBMs in the Medicare program.  However, the Department of Health and Human Services (HHS)  previously weighed in on prior authorization in the Medicare program, noting in 2008 that a prior authorization program could be “inconsistent with the public nature of the Medicare program,” since such programs rely on private companies using proprietary systems to deny care prescribed by a physician.  HHS also noted that the Medicare appeals process guaranteed to every beneficiary could overturn a “high proportion” of denials, rendering the policy ineffective.  In an environment of reduced reimbursements, the AMIC survey further demonstrates that application of RBMs is an ineffective model imposing unnecessary administrative costs on practices, thereby creating artificial barriers for patients in need of care.

    “We’re seeing a troubling potential shift in staffing allocation amongst physician practices and imaging providers, with clinical staff being replaced by administrative staff, as practices respond to the financial squeeze of Medicare imaging cuts and the simultaneous increases in imaging authorization approval demands created by RBMs,” said Trysla. “This reduction in supply of staff that provides crucial aid in patient treatment at physician practices and imaging providers is not good for care quality, and we need a system that prioritizes patient care before administrative paperwork.”

    The survey was conducted via phone and email channels, garnering 131 responses from AMIC’s physician membership. This is the second survey of physician practices and imaging providers commissioned by AMIC, the first of which was conducted in 2010 to measure the impact of previous reimbursement cuts.  Congress has cut reimbursements to medical imaging eight times in the past six years, dramatically slashing physician reimbursements for everything from mammograms and bone density scans to chest x-rays and brain scans.

    “Patient access to the right scan at the right time is already being jeopardized,” said Trysla.  “Policymakers need to ensure that additional cuts and administrative roadblocks are not put in place.”

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    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.

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