Radiology Reimbursement Cuts?

[drfunktacular]

Hans noted in another thread that radiology compensation is "set to take a huge cut in the next 4 years". I was just wondering if Hans or anyone else could fill me in a bit more on this prognostication, such as: how huge and why?

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[hans19]

Hans noted in another thread that radiology compensation is "set to take a huge cut in the next 4 years". I was just wondering if Hans or anyone else could fill me in a bit more on this prognostication, such as: how huge and why?

http://www.mpo-mag.com/news/2007/08...ng_payments_to_help_fund_children's_insurance

The problem is overutilization of imaging services. Clinicians not using their better judgement or lack of testicular fortitude and ordering studies on a whim. For fishing expeditions just in case. The other issue is clinicians self-referring to their own scanners due to financial incentives. Instead of getting at the root of the problem, the approach by lawmakers to stem expenditure on imaging, is to slash imaging reimbursement across the board.

 

[-Goose-]

Ouch.

Looks like a real Robin Hood steal-from-the-rich-give-to-the-poor kind of answer.

 

[Taurus]

Medicare is a zero sum game. They're just redistributing the money and no new money is coming in. All high earning fields will fall under the knife at some point. Radiology is still worth it even if we earn 1/3 of today's income.

 

[hans19]

Medicare is a zero sum game. They're just redistributing the money and no new money is coming in. All high earning fields will fall under the knife at some point. Radiology is still worth it even if we earn 1/3 of today's income.

It will help keep the opportunistic types out of the field and make it easier for those who are really interested in the field.

Sucks to have to take a pay cut, but if you love what you are doing who cares? Cardiologists will also take a hit. The cuts will also affect reimbursement for minimally invasive procedures affecting much of IR and interventional cardiology.


In the long run the cuts may make it less attractive for clinicians to pursue imaging since they don't have the economies of scale that a full-fledged radiology operation has. With improvements in PACS voice recognition and HIS integration, we will be able to handle enough volume of studies and stay profitable. Thats what happened when the last round of paycuts hit Radiology. At about that time PACS came into being and really improved efficiency so more studies could be read per unit time.

 

[f_w]

The SCHIP legislation in the process of being vetoed by the president this week has/had some provisions in it that will hurt radiology. The medicare $$s will go into different 'pots' like primary care and 'expensive frills'. Radiology will be in the 'expensive frills' pot together with some other growth areas. As a result, rads reimbursements are expected to decrease. I am not sure whether the post-conference version of the SCHIP bill still contains these provisions, but they are clearly a worrisome sign.

 

[nutcancer]

i'm one of these opportunistic types that has left this field. good luck everybody! i know for a fact i wouldn't enjoy my job if i got paid 1/3 of today's income.

 

[hans19]

i'm one of these opportunistic types that has left this field. good luck everybody! i know for a fact i wouldn't enjoy my job if i got paid 1/3 of today's income.

Thats one way to know radiology isn't for you. There are smart guys who got into rads, perhaps thinking it would be a way to make easy money, but they aren't really happy in the field and it shows. These people are miserable and its not fun working around them. At least you found out before you were too far invested into the application process. I respect the fact that you are being honest with yourself.

Good luck with whatever you decide to do!

 

[finallyMS3]

Thats one way to know radiology isn't for you. There are smart guys who got into rads, perhaps thinking it would be a way to make easy money, but they aren't really happy in the field and it shows. These people are miserable and its not fun working around them. At least you found out before you were too far invested into the application process. I respect the fact that you are being honest with yourself.

Good luck with whatever you decide to do!

do you really think pay will decrease by 2/3's? Is there any hope for rads salary? Do you think that new imaging technologies will keep salaries up?

 

[WaterAvatar]

Hey Nutcancer.... what did you end up going into then? Oncology? Urology?

 

[nutcancer]

i'm going to into cardiology. my plan is to set up a private practice in a wealthy area, rent some high speed CT scanners and some magnets, and self-refer/scare my patients into getting mildly justifiable cardiac imaging (as these technologies get more standard). how am i going to be liable for reading the rest of the chest? simple -- i'll just buy one of these new ct scanners that 'cancel out' the chest!

yes, i am what's wrong with modern medicine.

 

[nutcancer]

new imaging technologies usually make practicing radiology easier. which in turn makes stealing them by non-radiologists even easier.

 

[OHMAN0125]

do you really think pay will decrease by 2/3's? Is there any hope for rads salary? Do you think that new imaging technologies will keep salaries up?

I dont think 2/3s. But they will probably make 100K - 150K less than they make now, still not bad at all. But look what happened with general surgery when the hammer fell. Damn.

 

[finallyMS3]

I dont think 2/3s. But they will probably make 100K - 150K less than they make now, still not bad at all. But look what happened with general surgery when the hammer fell. Damn.

how hard of a hit did they take?

 

[freddydpt]

Out of curiosity, what would happen if all radiologists decided that they wouldn't take insurance any more? In order to get a study done, you would need to pay a sliding scale... politicians would have to pay more since they screwed everyone else over... it would also solve the over utilization thing pretty quickly.

 

[Taurus]

I dont think 2/3s. But they will probably make 100K - 150K less than they make now, still not bad at all. But look what happened with general surgery when the hammer fell. Damn.

You have to admit that radiologists gave the general surgeons some hurtin' because we took away some of their business.

 

[whournameiz]

I mean how much could they cut? So are radiologists being paid less than 20$ to read a film?

I thought radiology was pretty unified nationally in comparison to other organizations. Couldn't they just start denying medicare like most other offices?

 

[-Goose-]

I dont think 2/3s. But they will probably make 100K - 150K less than they make now, still not bad at all. But look what happened with general surgery when the hammer fell. Damn.

What are you referring to?

 

[lokobo]

I mean how much could they cut? So are radiologists being paid less than 20$ to read a film?

I thought radiology was pretty unified nationally in comparison to other organizations. Couldn't they just start denying medicare like most other offices?

the problem with that is most other third party insurers will follow suit after medicare changes their reimbursements, i think

 

[hans19]

i'm one of these opportunistic types that has left this field. good luck everybody! i know for a fact i wouldn't enjoy my job if i got paid 1/3 of today's income.

It won't be a 2/3 cut.

i'm going to into cardiology. my plan is to set up a private practice in a wealthy area, rent some high speed CT scanners and some magnets, and self-refer/scare my patients into getting mildly justifiable cardiac imaging (as these technologies get more standard).

If you forgot the details of the plan, it will hurt all who do imaging and minimally invasive procedures. That means cardiologists are gonna get it too!

I am what's wrong with modern medicine.

You said it best!

 

[f_w]

Apparently the provisions in the SCHIP renewal that would have reduced radiologies reimbursement have been removed in committee.

And if the exalted leader decides to veto the whole thing anyway, who cares.

 

[nutcancer]

my attempt at satire or humor has not been well received. i'm just kidding. i'm not going into cardiology. i was just trolling b/c i know how much you guys hate cardiologists. your point is well taken hans. i'm not doing rads not for the risk of reimbursment cuts but because i did a rotation in it and i hated every minute of it. if you truly enjoy enjoyed the work, the money shouldn't matter. everyone in medicine is entitled to decent reimbursement and even with cuts, radiology will still make some nice change (especially relative to what they do).

for all those people going into rads to go into private practice. if you hate what you do, how are you going to manage all those high volume reads, one after another another after another. it must be suffocating.

 

[Taurus]

if you hate what you do, how are you going to manage all those high volume reads, one after another another after another. it must be suffocating.

One word: rounding

 

[f_w]

but because i did a rotation in it and i hated every minute of it.

Good reason not to do it.

if you hate what you do, how are you going to manage all those high volume reads, one after another another after another. it must be suffocating.

If you hate it, it it suffocating. If you like what you do, plowing through some volume is not a problem.

 

[fun8stuff]

Good reason not to do it.



If you hate it, it it suffocating. If you like what you do, plowing through some volume is not a problem.

as a med student, is doing a rotation in radiology the best way to figure if you like radiology? my understanding is that a rotation really isnt that representative....

 

[f_w]

as a med student, is doing a rotation in radiology the best way to figure if you like radiology? my understanding is that a rotation really isnt that representative....

There is really no other way. Unfortunately, rads rotations are either
- poorly organized
- overorganized

They range from medstudents sitting behind people dictating for an hour a day (and then wandering off into the library or back to bed, the famours radholliday) to highly structured boot-camps with daily presentations and homework. Both extremes don't really serve to attract medstudents to the field.

 

[keithn12345]

Hey FW where did you find find out about SCHIP removing the provisions that would decrease reimbursement? It sounds like SCHIP expires at the end of the month and if el Jefe doesn't like the new proposal, an extension of the current policy will likely pass instead - does this sound correct?

 

[f_w]

Hey FW where did you find find out about SCHIP removing the provisions that would decrease reimbursement?

That was in one of the email circulars I get from the ACRs political action comittee. Apparently the senate isn't too hot about holding poor kids hostage to effect major changes in the greater healthcare system.

It sounds like SCHIP expires at the end of the month and if el Jefe doesn't like the new proposal, an extension of the current policy will likely pass instead - does this sound correct?

They will do what they allways do. Pass an extension bill and later roll it into a defense appropriation....