Radiology trends in Conn. tied to reimbursement

The Connecticut Department of Social Services (DSS) found that use of radiology services increased during a recent nine-month period in 2016, compared with a year ago, despite a 42.5% reduction in Medicaid reimbursement in the state last year.

According to a November 10 article from the Connecticut Mirror, the overall number of radiology claims rose along with utilization of hospital-based imaging services. On the downside, claims from independent radiology practices decreased and utilization of these facilities slipped by 16%.

The DSS noted 214,823 claims for hospital-based radiology services from June 1, 2015, through March 31, 2016, compared with 7,189 claims from independent radiologists during that same time frame.

The trends indicate that fewer Medicaid patients are being seen in outpatient radiology facilities and that they have fewer choices, said Dr. Thomas Farquhar, legislative co-chair of the Radiological Society of Connecticut, in the article.

DSS spokesperson David Dearborn said there has been no meaningful shift from community-based independent radiology facilities to hospital facilities, according to the article. Fewer than 5% of radiology claims historically have come from facilities that were not hospital-based, he added.

Radiologists used to be paid Medicare's rate in 2007; however, in March 2015 Connecticut reduced reimbursement to 57.5% of that level. As a result, the physician fee for a mammogram fell from $35.56 to $20.45. The fee for a shoulder x-ray dropped from $7.67 to $4.41, the article stated.

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