Screening Cuts Would Hurt Most In Rural States Like Arkansas, Group Says

FAYETTEVILLE — Arkansas and other rural states will get hit particularly hard by proposed cuts in Medicare for "advanced medical imaging" such as MRIs, supporters of breast cancer screening said Monday.

Worse, the change proposed by President Barack Obama's administration would cut back on prevention and greatly increase the cost of curing many problems, said radiologist Dr. Steven Harms of the Breast Center in Fayetteville. White House spokesmen had no immediate reaction to the remarks Monday.

The proposed rate is based on an assumption of how much an imaging machine is used. The more a machine is used, the more private paying customers pay the expense of the machine, in Medicare's formula. The current rates assumed for these machines is 50 percent, or five hours out of a 10-hour day at a clinic. The new rate would assume the machines would have a "utilization rate" of 95 percent. That kind of rate is impossible, critics said.

"When I was tested, they used different machines for different tests. It was impossible to keep them all in use on the same patient," said cancer survivor Robin Hall Guadagnini of Fayetteville. The only way to use all the machines for all the tests in full use all the time would be to use several at once on the same patient, she and doctors said.

The most active machines at the largest hospitals in the country can't maintain a utilization rate of more than 70 percent, Harms and Eric Hoffman, spokesman for the group, said. The 95 percent figure was clearly an arbitrary number picked to meet a budget goal, Hoffman said.

The bottom line is that the Medicare reimbursement rate for an MRI on the breast would drop about 20 percent, from $800 to about $640, and many doctors would no longer be able to afford to perform the procedures, Harms and his clinic staff said.

http://www.nwaonline.net/articles/2009/07/13/news/071409fzmedical.txt