DRA II: CMS Proposes Slashing the Technical Component Again

A proposed 90% equipment-utilization formula and brand-new lowball practice-expense data courtesy of the AMA will deal radiology a new round of cuts comparable to those contained in the DRA. The specialty faces dramatic cuts to the technical component in the proposed 2010 Medicare Physician Fee Schedule (MPFS), and these have triggered...

OIC Reimbursement: The Multipronged Attack

In an illustration used for hospital clients, analyst Shay Pratt pinpoints imaging centers for sale around the country: four independents on the market in California, a four-center chain in Kansas, and a larger chain in central Florida with an asking price of $22.5 million. The list, with size and price...

MSDRGs: Pitfalls and Opportunities

Ernest Glad, president of Cortell Health, Dallas, Texas, sees the 2007 CMS restructuring of the DRGs used in the inpatient prospective-payment system as an opportunity that many hospitals are currently squandering. The restructuring adjusts DRG weights based on the severity of a patient’s condition to improve the system...

Further TC Cuts Ahead?

Due to inequities in payment methodology, are providers of imaging services overpaid?

That question is raised, along with others, in a provocative article by Winter and Ray,¹ two analysts for the Medicare Payment Advisory Commission (MedPAC), that was published in a recent issue of Health Affairs. In...

Revised Anti-markup Rule: CMS Gets Creative

On November 19, 2008, CMS issued the Medicare Physician Fee Schedule (MPFS) for calendar year 2009. Consistent with the CMS trend of introducing substantive regulatory changes in payment rules, the MPFS Rule contained a number of significant revisions, including the closely watched anti-markup provisions applicable to diagnostic services other than clinical diagnostic...

The Dynamics of Reimbursement and High-quality Care

Access to high-quality patient care is a cornerstone of customer-focused service delivery, Michael A. Silver, PhD, says. In turn, that goal is supported by technology that enhances performance and allows the imaging provider to do more with less. Part of making less go further is maximizing reimbursement through better...