| To
date, the discussion about the rise in medical imaging in
this country has been largely one-sided as the radiology community
lobbies to put profits before patient care. As a cardiologist,
I appreciate the importance of cost-effective health care,
but I also recognize that price and value are not always equivalent.
With the introduction of any new medical breakthrough comes
a struggle to assess the clinical value and the proper application
of that technology in the best interest of the patient.
As
imaging modalities become more sophisticated and increasingly
integrated into patient care, their value to the practice
of medicine continues to grow. As a result, the volume of
imaging procedures performed in the United States is naturally
rising. Many medical trends point to this growth as appropriate:
a growing population of patients living with chronic illness,
a stronger emphasis on preventing illness, and a call for
disease management with a focus on clinical outcomes.
On
Jan. 12, the Medicare Payment Advisory Commission (MedPAC)
voted on its draft recommendations to Congress on managing
growth in medical imaging. The American College of Cardiology
(ACC) appreciates that the Commission is tasked with examining
the fiscal concerns of the Medicare program, but we question
the timing of these recommendations given the lack of credible
data to support them. It is incumbent on policymakers to take
a longer view of this important issue and to evaluate the
long-term health benefits of this technology in addition to
the immediate costs.
Keeping
this global view of imaging in mind, the ACC poses the following:
- How
can MedPAC recommend restrictive tactics to ratchet down
on utilization of computed tomography (CT), magnetic resonance
(MR) and positron emission tomography (PET) scans when studies
cited at MedPAC’s Jan. 12 meeting to support their
recommendations are biased and specifically exclude examination
of these modalities?
- Why
should providers be lumped into such broad categories as
radiologists and non-radiologists when many of the non-radiologists
performing diagnostic scans are expertly trained and duly
qualified to perform these tests?
- Should
Medicare become enmeshed in the business of accrediting
or credentialing physicians?
As
imaging becomes increasingly ensconced into the practice of
cardiology, the ACC will continue to work with our colleagues
in all medical specialties to ensure our patients have access
to the imaging care they need from providers who are trained
and qualified to perform these services. |
