In an effort to create a faster and more efficient workflow among physicians and their ability to view and share x-rays, the Medicare rate on computed radiography (CR) will be reduced to encourage providers to begin to use digital radiography (DR). Payment reductions will also be made on analog equipment but that is not expected to have nearly the impact that the CR reductions will. Many facilities upgraded to CR before DR was an option, and therefore today there are thousands of CR equipment being used in the United States.
What made the change come about?
Officially the reductions will come from provisions that were inserted into the Consolidated Appropriations Act of 2016, which was enacted into law in December 2015. The idea comes with the promise that the use of CR will speed workflow and create an environment that is more efficient for providers and patients alike.
How will the reductions work?
Beginning in 2017 reductions will be made on payments for any imaging done on analog machines. Starting in 2018, payments for imaging studies performed on CR equipment would be reduced by 7% for the next five years, and 10% after that. Imaging facilities will therefore have to decide whether to:
1. Spend the money to upgrade their CR equipment to DR (with integration into your certified EMR system) or
2. Not get paid as much. The anticipated reductions are between 7-10% in Medicare payments for x-ray studies beginning January 1, 2017. The proposed changes in the relative value units will be published in the proposed rule due out on or about July 1, 2016.
What about the patients?
The move to CR not only enables the patient to have quicker, more effective access to images, but it also exposes patients to less radiation then its counterparts. The biggest effect the new pay rates will have on patients is the ripple effect the lower pay rates from Medicare will have on providers and facilities already relying on slim resources.
What does this mean?
What it means is that the medical industry is making another step in the direction of efficiency as an unfunded mandate. What it also means is that a large number of facilities will have an expensive decision to make. Digital is clearly where medicine is headed, so the payment penalties could force some to bite the bullet quicker then they might have and invest in the latest and greatest the x-ray industry is offered. However, for those who cannot simply cannot afford to upgrade at this time, they will have to bear the brunt of the penalties until they are able to switch. For facilities that already struggle for funding these penalties could add up quickly and affect their ability to function.