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Scans allow doctors to diagnose and treat a variety of diseases and conditions. Here’s a bit more about each scan:

Computed Tomography: CT scans combine multiple X-ray images taken from different angles to produce precise, 3-D views of certain parts of the body. CT is often the preferred method of diagnosing many cancers, such as liver, lung and pancreatic cancers. Learn more.

Magnetic Resonance Imaging:  MRIs create detailed images of organs and tissues and have proven to be highly effective in diagnosing a number of conditions by showing the difference between normal and diseased soft tissues of the body. MRI scans often used to evaluate, blood vessels, breasts, organs in the pelvis, chest and abdomen, tendon and ligament tears, spinal injuries and bones and joints. Learn more.

Positron Emission Tomography: Physicians use PET imaging to determine how tissues and organs are functioning. PET is often used to evaluate neurological diseases such as Alzheimer’s and Multiple Sclerosis, heart conditions, cancer and effectiveness of treatments. Learn more.

Ultrasound: Diagnostic ultrasound sends sound waves into the body and is able to convert the returning sound echoes into a picture. Ultrasound is often used to evaluate pregnancy, abnormalities in the heart and blood vessels, organs in the pelvis and abdomen and symptoms of pain, swelling and infection. Learn more.

Radiation Therapy: Radiation therapy is used to treat a wide range of cancers by delivering highly targeted radiation to cancerous cells, destroying their ability to grow and divide while leaving healthy cells intact.

X-ray: X-ray technology is the oldest and most commonly used form of medical imaging. X-ray images are typically used to evaluate broken bones, lungs, blood vessels and breasts (mammography). Learn more.

Washington, D.C. – The Access to Medical Imaging Coalition (AMIC) today said that the Congressional Budget Office (CBO)’s scoring of President Obama’s FY14 budget confirmed that the use of prior authorization schemes for imaging within the Medicare program would produce no savings and impede Medicare beneficiaries’ access to life-saving imaging services.

 “CBO has confirmed that implementation of a prior authorization program will not only produce zero cost savings, it will insert an artificial barrier between physicians and their patients,” said Tim Trysla, Executive Director of AMIC.  “Seniors rely on medical imaging for early detection and to guide their treatment on the road to survivorship.  Instead of policies that harm patient access without yielding any cost savings to the federal budget, AMIC encourages Congress to advance policies that encourage the appropriate use of medical imaging.”

AMIC has long advocated against the use of prior authorization, such as radiology benefits managers (RBMs). There has been no scientific, peer-reviewed research on the safety, efficacy or impact on administrative costs of prior authorization and RBMs. In fact, empirical analysis of prior authorization and RBM systems in the private sector indicates that roughly 90 percent of RBM denials of coverage for imaging scans are ultimately overturned on appeal. As such, Congress should avoid establishing this type of prior authorization policy that will only create increased administrative complexity for providers and patients, without a measurable benefit for the Medicare program.

Additionally, medical imaging services have borne a disproportionate share of federal cost savings resulting from misguided payment cuts in recent years, with Congress and the Centers for Medicare and Medicaid Services (CMS) slashing Medicare payments for imaging services 12 times in the last seven
years. Applying a prior authorization policy in Medicare Fee-for-Service would only add to this inequity and threaten patient access to the early detection and disease management benefits that advanced imaging can provide.

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Washington, D.C. – The Access to Medical Imaging Coalition (AMIC) called on Congress today to reject terms in President Obama’s proposed 2014 budget that would harm patient access to advanced medical imaging technologies that have been proven to save lives through earlier detection and treatment. Specifically, the Administration has prior authorization requirements for advanced imaging in Medicare.

“President Obama’s budget would jeopardize patient access to care and important imaging services through burdensome prior authorization requirements,” said Tim Trysla, Executive Director of AMIC. “These policy recommendations are not supported by data, and ultimately, physicians, patients and caregivers will pay the price.”

Utilization of imaging services within Medicare has declined substantially since 2006, a downward trend that has been twice confirmed by the Medicare Payment Advisory Commission (MedPAC), which noted in its March 2012 Report to Congress that imaging represents the slowest growing category in the fee-for-service Medicare program.  Despite this trend line clearly showing reductions in the growth rate for imaging utilization, Congress reduced Medicare payment rates for imaging yet again in January 2013, marking the twelfth time that Medicare’s imaging reimbursement has been cut in the past seven years.

Meanwhile, there has been no scientific, peer-reviewed research on the safety, efficacy or impact on administrative costs of prior authorization and radiology benefits managers (RBMs). In fact, a study in the June 2011 issue of the Journal of the American College of Radiology found that relying on RBMs to conduct prior authorization for advanced imaging increases costs and red tape, placing a burden on physicians and potentially causing delays in treatment. Another study, commissioned by the Patient Advocate Foundation in April 2012 explored the impact of health coverage denials on patients seeking medical imaging exams, ultimately finding that, of the 4,360 patients who contacted PAF between 2007 and 2011 for help in accessing the test they needed, 81 percent of the insurance denials for imaging procedures were due to prior authorization programs – and 90 percent of the denials reversed were in fact covered by the patients’ health plans.

“Implementation of a prior authorization program will not only produce zero cost savings, it will insert an artificial middle-man between physicians and their patients,” said Trysla. “As an alternative to this misguided policy proposal, AMIC supports the adoption of physician-developed appropriateness criteria and the use of decision support tools, both of which have proven effective in driving appropriate imaging use without compromising patient access to the right scan at the right time.”

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The Access to Medical Imaging Coalition represents more than 100,000 physicians, medical providers, and patient organizations throughout the U.S. It also includes health technology firms that manufacture imaging equipment and supplies and that employ tens of thousands of workers. Thus, AMIC represents those who develop medical imaging technologies, those who apply it, and those who benefit from it.

“The Choosing Wisely assessment speaks to the importance of administering tests when medically appropriate,” said Tim Trysla, Executive Director of AMIC. “In using physician-developed appropriateness criteria, physicians are empowered to make individualized treatment decisions based on patients’ specific needs, thereby empowering both the doctor and the patient to determine a suitable treatment plan.”

Access to the right scan at the right time is critical to the early diagnosis, treatment and monitoring of countless diseases, limiting exposure to radiation, improving outcomes, and reducing costs. For over a decade, as medical imaging has all but eliminated the need for invasive surgery, appropriateness guidelines related to imaging have expanded significantly.

It is essential to promote policies such as appropriateness criteria that have already been developed and proven effective to ensure proper utilization of medical imaging technology without undercutting patient access and quality of care.

In fact, a number of recent studies have confirmed the benefits of empowering physicians to reduce inappropriate imaging through the use of appropriateness criteria. In September 2012, researchers highlighted simple and inexpensive ways in which incorporating SPECT appropriate use criteria in electronic medical records (EMRs) aided primary care physicians in ordering the right test for their patients.

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“The evidence is clear: access to advanced imaging technologies saves lives,” said Tim Trysla, Executive Director of AMIC. “The ACS endorsement of LDCT for high-risk individuals represents an important step forward in reducing mortality and healthcare costs associated with this devastating disease.”

The endorsement from ACS follows efforts by AMIC partner, the Lung Cancer Alliance (LCA), to elevate early detection and treatment of lung cancer to the national stage. In February of 2012, LCA announced a National Framework for Lung Cancer Screening Excellence and Continuum of Care to maximize the benefits of these tests and reduce access barriers to medical imaging technologies.

Additionally, the Department of Veterans Affairs has indicated it will commit to LCA’s Framework and began a phased implementation of LDCT in high-risk veterans last summer. Insurers are also recognizing the value of LDCT, with WellPoint including the scans as a covered benefit beginning late in 2011.

Lung cancer accounts for 160,000 deaths every year in the United States and has a devastatingly low survival rate when not detected early. Because symptoms of the disease are seldom detected until it has advanced aggressively, many patients do not receive a diagnosis until it is too late to receive effective treatment. However, peer-reviewed research has proven the value of medical imaging to early detection of the disease. The landmark National Lung Screening Trial, funded by the National Institutes of Health, and published in the New England Journal of Medicine in August 2011, showed LDCT could reduce death from lung cancer by 20 percent.

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The Access to Medical Imaging Coalition represents physicians, medical providers, and patient organizations throughout the U.S. It also includes health technology firms that manufacture imaging equipment and supplies and that employ tens of thousands of workers. Thus, AMIC represents those who develop medical imaging technologies, those who apply it, and those who benefit from it.

“By putting in place yet another payment cut for imaging, Congress has further reduced patient access to vital early diagnosis that we know saves lives,” said Tim Trysla, AMIC’s executive director. “Unfortunately rather than basing payment decisions on up-to-date data, which show imaging use on the decline, Congress is blindly slashing Medicare payments for diagnostics without true knowledge about how their previous cuts affect seniors’ access to early diagnosis services. We know that cuts which already have gone into effect have forced physician practices and providers to scale back on clinical staff and forgo technology upgrades. This additional cut will further exacerbate those problems closing additional free-standing imaging centers and forcing patients to either forgo life-saving imaging or receive a scan in hospitals where they are more expensive.”

Numerous recent studies have demonstrated imaging use per beneficiary and spending has declined. The Medical Imaging & Technology Alliance (MITA) released a report in the fall showing that imaging utilization per Medicare beneficiary declined by 5.12 percent since 2009 and spending on imaging services for each Medicare beneficiary has
dropped 16.7 percent since 2006. That report was echoed by policy brief from the Harvey L. Neiman Health Policy Institute that shows medical imaging utilization and spending has declined since 2006, while the average length of hospital stay in the United States has increased.

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Washington, D.C. – The Access to Medical Imaging Coalition (AMIC) today released a nationwide survey of 131 physician practices and imaging providers finding that practices and providers are being forced to scale back on staff and technology upgrades to adjust to the reduced Medicare payment environment.

“It’s no surprise that relentless cuts to medical imaging are having an adverse impact on physician practices and imaging providers and their ability to effectively serve patients,” said Tim Trysla, Executive Director of AMIC.  “Most worrisome are additional proposed cuts that will compound the access barriers that seniors face today.  Reducing access to early detection makes no sense as it will impair health outcomes and drive up costs over the long-term.”

With nearly 9 out of ten physician practices and imaging providers reporting a negative financial impact due to the payment cuts, 42 percent of practices said they were forced to reduce staff, while more than 24 percent of physician practices and imaging providers reported that they had to forego medical imaging technology upgrades.

The AMIC survey also revealed that while Medicare imaging cuts contributed to a reduction in staff that treat patients, physician practices and imaging providers are also facing growing administrative staffing pressures as a result of the increased use of Radiology Benefit Managers (RBMs) by private payers for pre- and prior authorization for imaging services.  More than 43 percent of practices and providers reported having to hire more administrative staff to juggle the additional bureaucratic strain posed by the use of RBMs.

In the past, the Obama Administration has proposed using RBMs in the Medicare program.  However, the Department of Health and Human Services (HHS)  previously weighed in on prior authorization in the Medicare program, noting in 2008 that a prior authorization program could be “inconsistent with the public nature of the Medicare program,” since such programs rely on private companies using proprietary systems to deny care prescribed by a physician.  HHS also noted that the Medicare appeals process guaranteed to every beneficiary could overturn a “high proportion” of denials, rendering the policy ineffective.  In an environment of reduced reimbursements, the AMIC survey further demonstrates that application of RBMs is an ineffective model imposing unnecessary administrative costs on practices, thereby creating artificial barriers for patients in need of care.

“We’re seeing a troubling potential shift in staffing allocation amongst physician practices and imaging providers, with clinical staff being replaced by administrative staff, as practices respond to the financial squeeze of Medicare imaging cuts and the simultaneous increases in imaging authorization approval demands created by RBMs,” said Trysla. “This reduction in supply of staff that provides crucial aid in patient treatment at physician practices and imaging providers is not good for care quality, and we need a system that prioritizes patient care before administrative paperwork.”

The survey was conducted via phone and email channels, garnering 131 responses from AMIC’s physician membership. This is the second survey of physician practices and imaging providers commissioned by AMIC, the first of which was conducted in 2010 to measure the impact of previous reimbursement cuts.  Congress has cut reimbursements to medical imaging eight times in the past six years, dramatically slashing physician reimbursements for everything from mammograms and bone density scans to chest x-rays and brain scans.

“Patient access to the right scan at the right time is already being jeopardized,” said Trysla.  “Policymakers need to ensure that additional cuts and administrative roadblocks are not put in place.”

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The Access to Medical Imaging Coalition represents physicians, medical providers, and patient organizations throughout the U.S. It also includes health technology firms that manufacture imaging equipment and supplies and that employ tens of thousands of workers. Thus, AMIC represents those who develop medical imaging technologies, those who apply it, and those who benefit from it.

“AMIC applauds the work of the Neiman Institute in developing this important policy brief, which calls attention to the negative impact that further reimbursement cuts to medical imaging could have on clinical outcomes,” said Tim Trysla, executive director of AMIC. “Patient access to advanced imaging technologies saves lives and can reduce long-term costs for the healthcare system by spurring early detection, diagnosis and treatment of disease.   It is essential that policymakers refer to the latest data on utilization and spending trends when contemplating cuts that would threaten patient access to life-saving imaging services.”

The report, which is the first policy brief produced by the Neiman Institute, suggests that the potential of an inverse relationship between the decline in medical imaging utilization and the increase in length of hospital stay should give policymakers pause in continuing to pursue additional cuts and restrictive policies until the downstream clinical and cost consequences are known.

The data cited in the report echoes a recent analysis from the Medical Imaging & Technology Alliance (MITA) that found imaging utilization per Medicare beneficiary declined by 5.12 percent since 2009 and spending on imaging services for each Medicare beneficiary has dropped 16.7 percent since 2006.

AMIC cautioned that the downward trends highlighted in the Neiman Institute policy brief are occurring at a time when research continues to underscore the tremendous value of imaging in improving outcomes and reducing costs.  Advanced medical imaging has been proven to reduce the number of invasive surgeries, unnecessary hospital admissions and length of hospital stays. In addition, medical imaging has been directly linked to greater life expectancy and declines in mortality rates.

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Washington, DC – Today, the Access to Medical Imaging Coalition (AMIC) submitted a letter to Congress signed by 22 leading patient advocacy organizations urging them to protect advanced medical imaging and radiation therapy services against further reimbursement cuts and radiology benefit manager (RBM) and prior authorization proposals that would limit patient access to care. With eight cuts to medical imaging reimbursements in the past six years, the letter was unveiled during a press conference on Capitol Hill in anticipation that these threatening proposals will be introduced again this fall.

“Patients cannot afford to lose access to these life-saving technologies that detect, diagnose and treat cancers and other diseases,” said Erika Hanson Brown, cancer survivor and founder of COLONTOWN, a letter signatory. “We urge Congress to consider the tremendous role that medical imaging and radiation therapy have played in the lives of countless patients who our advocacy organizations represent when they contemplate additional Medicare cuts to imaging as well as using prior authorization schemes in Medicare that will create additional barriers for patients seeking imaging.”

At the press conference, AMIC also warned that new data indicates patients are receiving fewer imaging procedures for the second year in a row. The new analysis from the Medical Imaging & Technology Alliance (MITA) found:

• Imaging utilization per Medicare beneficiary declined by 5.12 percent since 2009
• Spending on imaging services for each Medicare beneficiary has dropped 16.7 percent since 2006
• Medicare spending on non-imaging services has grown 21.3 percent since 2006.

“The fact that data continues to show that imaging utilization and spending are on the decline raises serious concerns about whether patients are receiving the care they need,” said Tim Trysla, Executive Director of AMIC. “Medicare cuts to imaging have rippled through diseases limiting patients’ access to early detection, which saves lives.  From PET scans to breast MRI to CT screening for lung cancer, reimbursements have been cut eight times in six years.  Further reimbursement cuts for imaging services or the implementation of a prior authorization program would only create additional, unnecessary barriers for patients in need of care.”

In the letter to Congress, the patient advocacy organizations note that by impeding access to needed imaging services and undercutting the benefits of early detection, subsequent cuts to Medicare reimbursement will actually result in greater long-term healthcare spending. Similarly, the use of a prior authorization program has been shown to significantly delay and even deny services to patients without yielding any significant cost savings for taxpayers over the long-term. An in-depth report by the Patient Advocate Foundation (PAF) examining 4,360 patient cases involving barriers to imaging access from 2007 to 2011 found that 81 percent of the insurance denials for imaging procedures were due to prior authorization programs, stating reasons ranging from “not medically necessary” to “benefit exclusion” to “necessary prior authorization needed to be obtained, according to a May 9, 2012 POLITICO op-ed by Nancy Davenport-Ennis, PAF’s Founder and Chief Executive Officer.

Rather than continuing to layer on draconian reimbursement cuts for imaging and radiation therapy services or imposing costly administrative barriers to care, AMIC urges Congress to support the widespread adoption of evidence-based, physician-developed imaging appropriateness criteria in conjunction with decision support tools to educate physicians. Adoption of established appropriateness criteria and clinical decision support will ensure that the decision to order a test remains in the physician’s hands, rather than a third party who does not have the patient’s best interests in mind.

Groups that signed onto the letter include: AMIC, American Liver Foundation, American Urological Association, Black Women’s Health Imperative, Bladder Cancer Advocacy Network, Chris4Life, Coalition for Pulmonary Fibrosis, Colon Cancer Alliance, COLONTOWN, Fight Colorectal Cancer, Gilda’s Club of Western PA, Hypertrophic Cardiomyopathy Association, Kidney Cancer Association, Lung Cancer Alliance, National Marfan Foundation, National Rural Health Association, Prevent Cancer Foundation, Society for Women’s Health Research, The Leukemia & Lymphoma Society, Us TOO International, YES! Beat Liver Tumors, and ZERO The Project to End Prostate Cancer.

AMIC has a long history of working to protect patients’ access to life-saving diagnostic and preventive imaging services and radiation therapy. This week, AMIC hosted the Right Scan Right Time Advocacy Academy to inform and educate passionate patient advocates about how to effectively engage their members of Congress in meaningful and impactful ways.

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The Access to Medical Imaging Coalition represents physicians, medical providers, and patient organizations throughout the U.S. It also includes health technology firms that manufacture imaging equipment and supplies and that employ tens of thousands of workers. Thus, AMIC represents those who develop medical imaging technologies, those who apply it, and those who benefit from it.

“Early detection of lung cancer has proven time and time again to save lives, and low-dose CT is an effective screening tool shown to significantly reduce mortality due to lung cancer,” said Tim Trysla, executive director of AMIC. “Access to screening and diagnostic tools like low-dose CT is critical for patients at high risk for a disease where early diagnosis is essential to treatment and survival. AMIC applauds the VA’s efforts to screen at-risk individuals and encourages more policymakers and healthcare providers to follow suit so that all patients have timely access to life-saving diagnosis and treatment.”

Lung cancer is the leading cause of cancer-related death in the United States, and because symptoms often do not appear until the disease has advanced, many patients do not receive a diagnosis until it is too late for effective treatment. Moreover, veterans are at an increased risk for lung cancer due to higher rates of smoking in the armed forces and frequent exposure to cancer-causing chemicals used in warfare.

A recent Journal of the American Medical Association (JAMA) study published in May 2012 indicated that low-dose CT screening of individuals at an increased risk for lung cancer results in significantly fewer lung cancer-related deaths.  The study’s findings further support results of the National Lung Screening Trial which proved that low-dose CT screening could reduce lung cancer deaths by at least 20 percent in a high-risk population of current and former smokers ages 55 to 74.

LCA, a member organization of AMIC, is a champion of lung cancer patients in the United States. The group’s efforts to increase access to CT screening for high-risk veterans comes on the heels of its recent, powerful awareness campaign, “No One Deserves to Die,” which aims to debunk the stigma and misperceptions associated with lung cancer patients.

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The Access to Medical Imaging Coalition represents physicians, medical providers, and patient organizations throughout the U.S. It also includes health technology firms that manufacture imaging equipment and supplies and that employ tens of thousands of workers. Thus, AMIC represents those who develop medical imaging technologies, those who apply it, and those who benefit from it.