Radiology Digest: News from the week of April 15, 2022.
Experts Advocate for ‘One-Stop-Shop’ Cancer Screening Approach to Address COVID-related Backlogs
By Marty Stempniak | April 14, 2022 | Included in Radiology Digest – April 15, 2022
Healthcare experts are advocating for a new “one-stop-shop” cancer screening approach, allowing patients to receive all such tests during a single visit to begin addressing COVID related backlogs.
Numerous studies have charted the pandemic’s outsized impact on these preventive exams, with one March analysis urging for “urgent attention” to address screening deficits. Others have charged that these trends are impacting minority populations who already suffer from worse cancer care outcomes.
In a recent American Journal of Preventive Medicine editorial, experts from several East Coast institutions asked the healthcare field to “reimagine cancer prevention and control.”
“As the U.S. begins to plan for a post-pandemic era, cancer screening must be prioritized with an eye on equity,” lead author Sarah J. Miller, PsyD, with the Icahn School of Medicine at Mount Sinai’s Department of Population Health Science and Policy, and colleagues wrote April 8. “A return to normal would mean continuing to operate under a flawed system that creates and maintains health inequities. This moment in time presents an opportunity and perhaps an obligation to build a more equitable healthcare system that prioritizes prevention and equity.”
They propose prioritizing screening efforts and moving away from a siloed strategy based around cancer sites. Patients should no longer have to make multiple appointments for breast, lung, prostate, cervical, colorectal, and skin cancer. A one-stop-shop approach would seek to streamline all aspects into one, including education, outreach, risk assessment, imaging, results and follow-up. Providers would need to coordinate with hospitals or clinics to provide radiologic procedures and other exams in a convenient location. And mobile solutions could offer an option for targeting those who live far from imaging centers, they noted.
To read more, go to Radiology Business.
Biden Admin Announces Plans to Alleviate Medical Debt Burden
By Victoria Bailey | April 13, 2022 | Included in Radiology Digest – April 15, 2022
The Biden-Harris administration has announced a series of reforms that aim to alleviate medical debt burden and increase consumer protections for Americans.
One in three adults across the country has medical debt, which can lead to several financial and health challenges. Individuals may avoid seeking healthcare services for fear of furthering their debt.
Past-due medical bills may also appear on consumer credit reports, which can lower consumer credit scores and make it difficult for individuals to access credit, employment opportunities, and secure housing.
The Biden administration’s plan to address the burden of medical debt includes a directive from HHS Secretary Becerra on medical billing practices. Becerra will direct HHS to evaluate how provider billing practices affect care access and affordability, the announcement stated.
HHS will request data from more than 2,000 providers that detail medical bill collection practices, lawsuits against patients, financial assistance, financial prod uct offerings, and third party contracting or debt buying practices.
The Department will consider this information and publicly publish data and policy recommendations regarding medical bill collection practices. In addition, HHS will inform enforcement agencies of potential violations.
The Consumer Financial Protection Bureau (CFPB) also plans to investigate credit reporting companies and debt collectors that violate patient rights and hold the violators accountable. In addition, CFPB will monitor credit reporting and determine if credit reports should include past-due medical bills.
CFPB will also increase its consumer education tools to help individuals and families better understand medical billing processes, including materials and resources specifically designed to help consumers access financial assistance.
Data has shown that medical debt is not a good indicator of credit quality, the announcement noted.
Three nationwide credit reporting agencies—Equifax, Experian, and TransUnion—recently announced that they will remove nearly 70 percent of medical debt collection tradelines from credit reports and will no longer list past-due debt under $500.
However, a third of Americans have medical debt over $500, with 11 million reporting debt over $2,000 and 3 million with debt that exceeds $10,000.
To address this, the Biden administration has provided guidance to all agencies to eliminate medical debt as an underwriting factor in credit programs.
To read more, go to Revcycle Intelligence.
HHS Extends COVID-19 Public Health Emergency for Another 90 Days
By Robert King | April 13, 2022 | Included in Radiology Digest – April 15, 2022
The Department of Health and Human Services (HHS) has extended the COVID-19 public health emergency for another 90 days and potentially for the final time.
The PHE, which gives key flexibilities to providers and states, will not expire in July. The PHE was originally expected to expire April 16.
It remains unclear whether HHS will extend the emergency for a second time this summer, but providers will likely know the answer in a month. HHS Secretary Xavier Becerra has promised a 60-day heads-up to providers and states that the PHE will end.
The PHE went into effect in 2020 at the onset of the pandemic and granted major flexibilities to providers and states. It gave more flexibility to providers to waive key reporting requirements and removed barriers to telehealth reimbursement under Medicare.
In addition, states may not drop anyone off Medicaid rolls for the duration of the PHE. States are readying to examine thousands of Medicaid enrollees to redetermine whether they are eligible.
Some members of Congress and provider groups have wanted HHS to give even greater lead time, but Becerra has indicated he will not go beyond the 60 days. He has also previously said any decision will be based on the science and the status of COVID-19 in the country.
COVID-19 cases have spiked in recent weeks due to a new subtype of the omicron variant.
To read more, go to Fierce Healthcare.
Startups Eye Cash Pay to Tackle Rising Employer Healthcare Costs
By Nona Tepper | April 12, 2022 | Included in Radiology Digest – April 15, 2022
A growing number of startups think they have found the solution to employers rising healthcare costs: cash.
Sidecar Health launched its first fully insured health plan for companies on Monday, after opening its first plan for self-insured employers at the beginning of 2022. Cash pay competitor Sesame jumped into the employer fray in February, launching a virtual plan for small- and medium-sized businesses. Friday Health Plans said it grew its membership more than 300% year-over-year in part by focusing on employers that wanted to offer individuals a stipend to buy coverage off the Affordable Care Act exchanges.
Hospitals often set lower, discounted cash prices for common procedures than their insurer negotiated rates, according to a recent study published in JAMA Network Open. By taking advantage of these rates, Sidecar claims the new plan will save employers an average of 39%
compared with traditional health insurance companies. Direct-pay also eliminates the administrative burden doctors and patients face when navigating the traditional insurance industry, said Dan Korpman, Sidecar’s head of business development.
The company already counts at least one, Ohio-based company as a customer of its self-insured plan, Korpman said. During Sidecar’s last funding round in January 2021, the startup was valued at more than $1 billion.
“The user experience is very much like Expedia,” Korpman said. “It’s actually the experience that you have paying for pretty much anything else. You search for the price, shop for care, go get the care and you pay for the service.”
To read more, go to Modern Healthcare.
Imaging Industry Advocate Slams Feds’ Failure to Address PET Coverage Gap in Recent Ruling
By Marty Stempniak | April 11, 2022 | Included in Radiology Digest – April 15, 2022
An imaging industry advocate is blasting the Centers for Medicare & Medicaid Services’ failure to address PET coverage gaps in a recent ruling.
The agency revealed its final payment policy for controversial Alzheimer’s drug aducanumab (brand name Aduhelm) on Thursday, April 7, limiting coverage to government-approved clinical trials. “To the disappointment of many,” the decision included no added coverage for beta-amyloid PET imaging, used to detect such plaques in the brain, the Society for Nuclear Medicine & Molecular Imaging said Friday.
Instead, CMS will keep its current policy, only paying for these scans as required by clinical trials, limited to one per patient per lifetime. Meanwhile, other beta-amyloid tests such as cerebral spinal fluid sampling are covered without limitations, despite PET serving as the standard of care, the group said.
“We are disappointed that in its final decision, CMS did not modify its original proposed coverage of one beta-amyloid PET scan per person per lifetime,” SNMMI said in its April 8 statement. “We expressed our strong opposition to this proposal. There is no evidence to suggest that a single amyloid PET scan per patient is appropriate or that a scan performed years ago can provide the diagnostic information needed to determine whether a patient is currently a candidate for therapy.”
To read more, go to Radiology Business.
‘Surprising’ Decline in Annual Screening Among Breast Cancer Survivors has Experts Concerned
By Hannah Murphy | April 8, 2022 | Included in Radiology Digest – April 15, 2022
A drop in annual mammographic screening rates among breast cancer survivors has some experts questioning the barriers that might be preventing patients from seeking follow-up imaging.
In the April issue of the Journal of the National Comprehensive Cancer Network, researchers disclose that annual screening rates declined by 1.5% per year from 2009-2016. These declines were even more pronounced in survivors ages 40-49, for whom the rates dropped by 2.8% per year during that time.
“I was surprised that we saw declines in mammography use among patients who were continuing to see their cancer specialists. It suggests we are seeing less frequent mammography participation even among those who are otherwise engaged in their cancer care,” said lead researcher Kathryn P. Lowry, MD, assistant professor of radiology at the University of Washington School of Medicine in Seattle.
Lowry explained that although most women do well after completing breast cancer treatments, some will experience recurrence or go on to develop new cancer. Annual mammographic screenings can detect any recurrences or new cancers in the early stages of development, making treatment options and outcomes more favorable.
Using a nationwide commercial and Medicare Advantage claims database, researchers retrospectively analyzed the annual mammography screening rates among cancer survivors that took place between 2004 and 2016. This resulted in a cohort of 141,672 women ages 40 to 64 years who had a personal history of breast cancer.
To read more, go to Health Imaging.
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