The recent announcement of the final rules on Medicare reimbursement by CMS could result in a mass shuttering of rural clinics, according to the American College of Radiology.

In a statement released this week, the physicians group warns that the cuts to imaging services, believed to reach 16 percent across modalities, could endanger rural or small-town clinics, and limit access to life-saving techniques to patients nationwide.

"These short-sighted, unfounded and misguided cuts will imperil community-based imaging, restrict access to cutting-edge imaging scans, and delay diagnosis of cancers and other critical conditions which may ultimately cost lives," James Thrall, M.D., chair of the American College of Radiology's board, said in the statement.
In the rules announced Friday, CMS, as predicted, raised the expected utilization rates of imaging equipment costing more than one million dollars at non-hospital advanced imaging centers from 50 percent to 90 percent. This means the CMS, believing pricey diagnostic tools like MRI and CT scanners are in near-constant use, will slash their reimbursements per procedure. (DM 9554)

While the ACT believes this will result in a 16 percent cut across the board, certain modalities - such as CT scans of the spine - will see up to 40 percent in cuts.

This loss of income, coming only a few years on the heels of the Deficit Reduction Act of 2005*, which also heavily ate into freestanding clinics' finances, might prove too much for many centers.

"You're looking at another round of double-digit cuts," Shawn Farley, a spokesman for ACR, tells DOTmed News. "If your center does more MRI and CT, those are the hardest hit on the fee schedule announced on Friday, that's 30, 40, even 50 percent cuts in a three-year period. I don't know how a medical practice can absorb that level of cuts in so short a time and keep the doors open, especially in outlying areas."

In fact, according to surveys recently conducted by the Radiology Business Management Association (RBMA) and the ACR, almost 40 percent of such centers said they would consider closing shop once the cuts hit, and over a third said they might drop or limit access to Medicare beneficiaries. (DM 9421)

Yet the ACR doesn't think the absolute number of imaging units will decrease; rather, they say the real trend will be toward consolidation, far-flung rural or suburban branches closing down in favor of urban or regional centers. Already, a little under half of all clinics polled in the ACR survey said they were thinking of consolidation.

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