Here’s What WC Payers Should Look For in a Diagnostic Imaging Center

By: | May 3, 2019

Kent Spafford has been Company Advisory and Board Member at One Call since 2013. Kent previously served as the CEO and President of One Call. He can be reached at [email protected]

A recent study by AXREM quoted a decrease in overall radiology equipment spending in the UK. The study points out that as spending decreases, investments in new equipment could decline, contributing to the use of aged equipment.

According to a 2017 survey of the UK’s National Health Service (NHS) by the Clinical Imaging Board, 58% of MRI systems were more than five years old and 29% were more than 10 years old. This study has gained ample attention in the radiology community. With significant cuts to Medicare reimbursements and equipment costs only rising, we are likely facing a similar trend here in the U.S.

Advertisement




Although it may be easy to speculate a direct correlation between aging MRI equipment and subpar outcomes, such a view is misguided. Older MRI machines can be upgraded to state-of-the-art systems by adding new coils and the latest software. These upgrades cost only a small fraction compared to the cost of a new system, and ultimately provide the same performance. Most independent testing facilities have opted to upgrade rather than purchase new equipment.

While the age of diagnostic equipment is important, many interdependent factors should be considered to understand the quality of an individual diagnostic testing center.

These factors include, but are not limited to:

  • The type of equipment in use
  • Current software version
  • Magnet strength of equipment
  • Type of modalities offered
  • Qualifications of the radiologist or experience of the technologist
  • Treating physician preferences
  • Location and access to center
  • Direction of care regulations

It is important to note that while spending on diagnostic imaging equipment has waned in the U.S., there are entities that exist to ensure the quality delivered by testing facilities are diagnostically sound. Centers for Medicare & Medicaid Services (CMS) award accreditation to organizations, like the American College of Radiology, for delivering high practice standards and quality imaging.

To obtain accreditation, centers must go through a rigorous peer-review and evaluation process performed by board certified radiologists and medical physicists. They review the center’s image quality and procedures, personnel qualifications, quality control procedures, adequacy of facility equipment, and quality assurance program.

All providers should be accredited by one of the four CMS-designated accreditation organizations or have undergone a stringent peer review process.

Although becoming accredited is a voluntary process, CMS has adopted regulations that require centers to have standing accreditations to bill for services, and some states have done the same for workers’ compensation. All providers should be accredited by one of the four CMS-designated accreditation organizations or have undergone a stringent peer review process.

In summary, the judicious development of a diagnostic imaging network with comprehensive and ongoing credentialing of providers and their radiologists is critical. When this happens, patients can be fully confident they are accessing a high quality network that will lead to sound results and improved outcomes. &

More from Risk & Insurance

More from Risk & Insurance

Risk Matrix: Presented by Liberty Mutual Insurance

10 Risks Becoming More Severe Due to Climate Change

Climate change is generating powerful storms, excess flooding and billions in damages. These are the risks insurers need to keep an eye on as temperatures increase.
By: | September 3, 2019




The R&I Editorial Team can be reached at [email protected]