US Medicare Incentivizes Transition to DR

The US Centers for Medicare & Medicaid Service (CMS; Baltimore, MD, USA) will reduce payments for exams performed on analog X-ray systems, starting in 2017.

The decision is part of an incentive for providers to transition from traditional X-ray imaging to digital radiography (DR). The provisions, which are part of the USD 1.1 trillion omnibus spending bill passed by the US Congress in mid-December 2015, include a 20% reduction in the reimbursement for the technical component associated with X-rays taken using film. Other provisions include an incremental reduction of 7% each year between 2018 and 2022 in the reimbursement for the technical component of imaging services that rely on computed radiography (CR) technology; starting in 2023, payment will be reduced by another 10%.

The legislation, which is part of The Consolidated Appropriations Act of 2016, further sets the multiple procedure payment reduction (MPPR) at 5% for the professional component of imaging services furnished on or after January 1, 2017, a reduction that replaces the 25% MPPR that was specified in the CMS final rule of 2011. According to a 2013 X-ray market report by the IMV Medical Information Division (Columbia, MD, USA), the number of film-based systems operating in the US has fallen to miniscule levels, comprising just 1% of the installed base at US hospitals, down from 5% in 2010.

And while CR made up 55% of new digital X-ray sales in 2006, that number fell to just 6% in 2015, with the rest of digital X-ray sales made up by DR. The technology still makes up a significant part of the installed base of digital X-ray systems, unlike analog X-ray, with an estimated 8,545 systems installed at hospitals in the US (not including mobile units or systems installed at outpatient locations). Imaging facilities will therefore have to decide whether to spend the money to upgrade their CR equipment to DR, or swallow a 7% to 10% reduction in payments for X-ray studies.

The US Congressional Budget Office (CBO; Washington DC, USA) estimates that the provisions would save USD 352 million over 10 years for the technical component, and almost USD 2.85 billion over 10 years for the professional component.

Related Links:
US Centers for Medicare & Medicaid Service
IMV Medical Information Division