Medical Imaging – The Issue

It was a pretty full day and a half in DC so I will post several entries. But to start, I thought I would get to the core of it. The purpose of going was to meet with members of Congress on the relatively narrow issues surrounding medical imaging. The brief version of the talking points is that 1) the Deficit Reduction Act of 2006 cut Medicare reimbursements for imaging (MRI, CT scans, etc) by 20% 2) the Senate and House health reform bills use further cuts in reimbursement and an excise tax on equipment manufacturers to pay for the bill 3) the coalition of manufacturers, doctors and patient advocacy groups is asking congress not to cut as deeply on the reimbursement and not pass the excise tax. If both go through “as is” in the Baucus (Senate) bill, there is deep concern that access to imaging will be severely restricted or unavailable.

Medical imaging can actually save money – but it’s more difficult to “prove a negative” statistically so I will give you my personal example. Earlier this year, I was on the drug Avastin at a cost of about $10,000 per month. Because of the severity of the side effects, I asked the doctor about coming off of it (something he was hesitant to do). We decided that, if my next scan was stable, I could come off Avastin. That scan (and every scan since) has been stable. So, for the cost of about 4 scans (at $2,000 each or $8,000 total), I have not taken Avastin – which would have cost about $60,000 total since the spring. Hence, monitoring and adjusting my meds through the use of the MRI has saved my insurer about $52,000 this year. I used this example with the Members I met.