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Speaking to an audience at AHRA’s annual meeting Wednesday, consultant Bob Maier provided a clear warning for hospital radiology departments: You are going to lose a significant part of your business if you don’t find a more cost effective way to provide imaging services.
Maier, CEO of Regents Health Resources, spoke about succeeding in medical imaging in the coming decade. Part of his presentation included data from a radiology benefits management (RBM) firm detailing 20 MRI providers in both the hospital and outpatient imaging center environment. The facilities’ charges for an MRI exam ranged between $332 and $1,399 (some were global fees some were hospital technical components). The average cost was $660. All 20 of the facilities had quality ratings of at least 94 out of 100. The highest and lowest priced provider had identical quality scores of 97, negating any meaningful quality argument. Given roughly equivalent quality measures, it only makes sense that the RBM will steer patients to lower cost facilities.
RBMs (of some type) figure to be part of imaging’s future. They’ve been touted by the administration to curtail utilization and studies have shown that, at least initially, they do. Perhaps a best-case scenario for imaging would be some sort of criteria-based automated preauthorization that would eliminate the steering effect that RBMs have shown.
Information like Maier presented will also become more widely available and used by consumers as part of the growing trend toward healthcare cost transparency. Higher deductibles on health insurance policies and larger copays will make cost a much bigger issue. When insurance is footing most of the bill and the consumer really isn’t aware of the cost, patients will choose the most convenient facility or go wherever their doctor recommends. If more money is coming directly out of their wallets, more people will choose the $332 MRI over the $1,399 scan.
Maier told the imaging center crowd in attendance that if hospitals competing in their market aren’t cognizant of the cost difference between hospitals and imaging centers, it presents imaging centers a great opportunity to wrest business from the hospital.
Maier also said that CMS certainly is aware of the disparity between hospital and imaging center reimbursement, and will likely try to move hospital rates down toward outpatient rates.
Maier’s point is important: Competing on cost and customer service — both areas where Maier sees imaging centers generally outperforming hospitals — will be important for hospital imaging to stay as successful as its been in the past. While a hospital can count on retaining inpatient and emergency department imaging, they must also be competitive in the outpatient sector to keep diagnostic imaging a top contributor to the bottom line.
— Source: RadiologyTodayBlog
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