Publications & Research

Optimal Utilization Of Advanced Diagnostic Imaging Equipment: Principles and Implications

Authors:
Access to  Medical Imaging Coalition, Dr. David W. Lee, Dr. David Butz, September 2009

Summary:
Diagnostic imaging services performed in independent diagnostic testing facilities (IDTFs) or physicians’ offices are reimbursed under the Medicare Physician Fee Schedule. Payments for the direct costs of these services are determined in accordance with Medicare’s policy that beneficiaries should have access to these services during standard business hours, and that imaging equipment should be in use 50% of the available time. MedPAC recently recommended increasing this utilization factor to 90% for medical equipment costing over $1 million, such as computed tomography (CT) and magnetic resonance (MR) imaging systems. Although MedPAC’s stated intention is to improve “payment accuracy” and base payments on costs borne by an “efficient provider,” increasing the utilization factor to 90% contradicts basic workflow principles, is not supported by any currently available data, and has significant potential to disrupt the balance between patient access and health care costs.

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