Welcome to my narrow view of a huge industry dedicated to diagnostic and therapeutic imaging of disease. An interesting thing happened to the burgeoning imaging center business recently related to significant cuts in technical component reimbursement on the medicare fee schedules. Significant would probably be an understatement in some cases.
For people who don't understand imaging reimbursement, outpatient imaging consists of two payments from Medicare, a technical component and a professional component. The professional component is for the professional interpretation of that particular test, and the technical component is the fee paid for the equipment or infrastructure part of the test. In many cases this fee is paid together as a 'global' payment if the provider of the imaging service provides both professional and technical services. Many private insurers and HMO base their reimbursement on the medicare schedules usually paying anywhere from 90% to 125% of the medicare fee schedules.
This does not impact inpatient services because in most cases, a patient is admitted under a DRG and no matter how long or short the stay the money is the same on that DRG (oversimplified) so imaging costs on the technical side are lumped into the DRG reimbursement.
Up until recently the imaging portion of the medicare budget has been growing at a pace far exceeding any other category. This budget cut however is aimed at reducing that growth.
What does this really mean? I think we will see imaging center growth slow from its frenetic pace, operating margins will slim down and established players will take over while marginal
centers will close.
It also means that the latest 64/128 slice CT scanner that costs $2.1 million won't be worth the investment as outpatient imaging.
11Blade
