Radiology Digest: News from the week of June 14, 2021.
Radiology Could See Surge in MR Imaging Volumes Following Approval of Blockbuster Alzheimer’s Treatment
By Marty Stempniak | June 09, 2021 | Included in Radiology Digest – June 14, 2021
Radiology providers see opportunity on the horizon following the approval of Aduhelm, Biogen’s blockbuster new Alzheimer’s treatment, on Monday.
Screening patients for access to the drug will necessitate either a PET scan or lumbar puncture, experts noted. And individuals will also require a baseline MRI within one year before treatment and two more exams prior to subsequent infusions.
As cases of Alzheimer’s climb, so too will the number of individuals receiving Aduhelm, a controversial amyloid beta-directed antibody purported to attack the underlying cause of the disease. Drugmaker Biogen estimates more than 1.5 million patients will be eligible in the U.S., and instances of the disease are anticipated to double by 2050, up to 13 million.
Radiology providers are taking notice. Publicly traded imaging center operator Akumin sent an alert to investors Wednesday highlighting the “important implications.”
“Given that (a) patients seeking access to Aduhelm could be screened via PET scans; and (b) all patients receiving the treatment will require several MRIs, it is highly likely that industry players like Akumin will benefit from increased volumes for these modalities,” R. Jeffrey White, MBA, director of corporate development and investor relations, wrote June 9.
Following the U.S. Food and Drug Administration’s approval, fellow publicly traded imaging operator RadNet saw its stock jump 21%. Chief Financial Officer Mark Stolper could not pinpoint the source of such investor interest. But he said spectators could likely attribute the uptick to an anticipated uptick in brain scans.
RadNet operates a network of nearly 350 outpatient imaging centers across states that cover more than 25% of the U.S. population. Theoretically, the company could serve some 500,000 patients eligible for Aduhelm, he noted.
“While there is much to continue to be worked out—such as reimbursement for these diagnostic tests by Medicare and the private health plans—this remains an exciting opportunity for RadNet and the rest of the diagnostic imaging industry offering advanced imaging,” Stolper told Radiology Business.
Akumin did not see the same bump in its stock, up 2% during the same period. But White said he sent the alert after a large trade of its shares—roughly 1 million, or 10 times the average daily volume—on Tuesday. The Plantation, Florida-based company operates 134 outpatient imaging centers across the U.S. and has excess capacity to absorb a substantial swell in demand.
To read more, go to Radiology Business.
FDA’s New Drug Approval Means Little If CMS Won’t Update Amyloid PET Policy, Imaging Advocate Says
By Matt O’Connor | June 08, 2021 | Included in Radiology Digest – June 14, 2021
A leading imaging trade group says federal health administrators need to update PET scanning reimbursement policies to ensure patients can access a newly approved treatment for Alzheimer’s disease.
Just yesterday, the Food & Drug Administration announced its controversial decision to greenlight Biogen’s Aduhelm (aducanumab) drug. Patients with any stage of Alzheimer’s will have to undergo a brain PET scan to show the presence of beta-amyloid in order to receive treatment.
While the FDA approved amyloid PET scans in 2012, Medicare doesn’t currently cover such imaging, which is the most accurate and least invasive method for detecting amyloid, the Medical Imaging & Technology Alliance said June 8. It’s calling on the U.S. Centers for Medicare & Medicaid Services to change that.
“CMS should revise the legacy coverage and payment policies that will hinder access to this life-changing treatment,” Executive Director Patrick Hope said in a statement on Tuesday. “Specifically, MITA calls on CMS to expeditiously open the amyloid PET reconsideration request that has been pending before the agency since September 2020 to ensure appropriate Medicare access.”
A massive project launched in 2016, known as the IDEAS study, found adding amyloid PET imaging altered management in 60% of patients with mild cognitive impairment and dementia. In 36% of cases, there was a change in diagnosis. But amyloid imaging agents are still not covered unless approved under a Coverage with Evidence study, MITA noted.
In its June 8 request, the imaging advocate said it’s time to expand access and also update Medicare’s packaged payment policy for radiopharmaceuticals in order to ensure patients have access to amyloid diagnostic tests.
“The action taken … by the FDA will give patients and caregivers access to the first-ever Alzheimer’s disease-modifying treatment,” Hope explained. “Now, CMS needs to act to update its outdated coverage and payment policies and provide patients with access to amyloid PET diagnostic drugs.”
To read more, go to Health Imaging.
Healthcare Execs Say Digital Transformation is Speeding Up
By Amy Baxter | June 08, 2021 | Included in Radiology Digest – June 14, 2021
The vast majority of health care executives say digital transformation across their organizations is accelerating, according to a recent survey of 399 executives from six countries.
The faster pace of digital transformation was partly brought on by the challenges of 2020, which also made evident that every business is actually a digital organization. Without being able to connect in person, in offices during the COVID-19 pandemic, businesses quickly adapted and rolled out new collaborative technologies.
In healthcare, where digital adoption has been slow compared to other industries, the circumstances forced many to quicken their plans to bring enterprises up to date. Nearly all (93%) of healthcare executives in the survey said their organization was innovating with urgency and calls to action this year.
The Accenture Digital Health Technology Vision, conducted by Accenture, found five key trends that health care companies will need to address over the next three to five years to accelerate change across their organization.
The five trends include:
Under New Legislation, Medicare Would Cover Radiology Assistants’ Services In All Settings
By Marty Stempniak | June 07, 2021 | Included in Radiology Digest – June 14, 2021
Medicare would cover radiology assistant services in all healthcare settings under new national legislation introduced this month.
U.S. Rep. Mike Doyle, D-Penn., unveiled his Medicare Access to Radiology Care Act (MARCA) on June 1, drawing support from the imaging industry. The bill would amend the Social Security Act and align federal payment policy to match state licensure laws.
Advocacy groups including the American Society of Radiologic Technologists and ACR are now urging other representatives to cosponsor the law. Its passage would ensure
reimbursement for RA services whether delivered in a hospital, ambulatory surgery center or other facility, they said Monday.
“By not separating radiologist assistant reimbursement policies into different payment categories by service location, the adoption of MARCA would enable radiologists to devote more focused time to reviewing and interpreting complex medical images or urgent cases, thus increasing patients’ access to care,” the American Society of Radiologic Technologists said on its website. “RAs will be able to work more efficiently, and Medicare patients will receive care from qualified RAs regardless of the facility in which their procedure takes place.”
Such certified radiographers are rigorously trained and can safely perform certain assessments and procedures traditionally delivered by radiologists. But absent passage of House Resolution 3657, the rad assistant profession is “in peril,” with RAs losing their jobs and left unable to practice to the full extent of their training, ASRT said.
Following its introduction last week, the House has referred HR 3657 to the Energy & Commerce and Ways & Means committees for further review.
To read more, go to Radiology Business.
Big Business Wants to Take on D.C.’s Hospital Lobby
By Jessie Hellmann | June 07, 2021 | Included in Radiology Digest – June 14, 2021
Groups representing some of the largest employers in the U.S. are urging Congress to take on hospitals, arguing consolidation and unfair pricing is driving healthcare costs up at an unsustainable rate.
Corporations previously tended to stay out of controversial healthcare fights on Capitol Hill that would create more government intervention in private markets. But with the average cost of an employer-sponsored family healthcare plan increasing 55% over the past ten years, and most Americans getting insurance through their jobs, something has to change, lobbyists and experts say.
“In the past, I think they’ve been kind of skeptical of government solutions, but I think that the frustration has bubbled over to the point now that they’re saying ‘no, we actually need someone to help,” said Shawn Gremminger, director of health policy at Purchaser Business Group on Health, which represents dozens of large businesses who fund their own insurance plans and assume the financial risk of paying for their employees’ healthcare, including Boeing, eBay, The Walt Disney Company, Walmart and others.
Democrats have put more of a focus on “fair” pay and workers benefits as they control Congress and the White House. Employers say healthcare affordability needs to be part of that conversation.
About 83% of covered workers have an annual deductible for individual coverage — an increase of 25% from five years ago — with an average of $1,644 per year, according to the Kaiser Family Foundation. Research shows high-deductible plans can lead people to putting off necessary care, particularly for low-income populations and people of color.
PBGH and the Kaiser Family Foundation released a poll in April that found 87% of the 300 executive decisionmakers surveyed believe the cost of providing health benefits to employees will become unsustainable in the next five to 10 years.
A similar percentage said a greater government role in providing coverage and containing costs would be better for their businesses and their employees.
To read more, go to Modern Healthcare.
Imaging Advocates Offer Guidance After Reported Spate of SPECT/CT Payment Denials
By Mary Stempniak | June 07, 2021 | Included in Radiology Digest – June 14, 2021
Radiology industry advocates are offering guidance after a recent rash of SPECT/CT payment denials.
The Society of Nuclear Medicine & Molecular Imaging said Thursday that it’s received “many complaints” from the field pertaining to various commercial payers. SNMMI has now created a sample response letter to help providers fight this payment roadblock.
“We believe there is a fundamental lack of understanding in commercial payers’ medical review panels regarding the everyday clinical value of SPECT/CT to physician clinicians across all geographic regions and at all major hospital systems in the United States,” the society said in a June 3 news
. “We hope that the reasons stated and literature cited in this letter will [emphasize] the value of SPECT/CT and its need for commercial payer coverage.”
Health insurers including Humana have recently labeled this nuclear imaging technique “investigational” and not medically necessary in certain scenarios. This is despite “significant scientific scrutiny” prior to the Centers for Medicare & Medicaid Services reimbursing for these exams, SNMMI noted.
The Reston, Virginia-based advocacy group said the medical necessity letter is the result of months of work from its Coding & Reimbursement and Government Relations committees. Several industry partners also reviewed the document, which can be accessed for free here.
To read more, go to Radiology Business.
American College of Radiology Opposes Rebranding Physician Assistants as ‘Associates’
By Marty Stempniak | June 07, 2021 | Included in Radiology Digest – June 14, 2021
The American College of Radiology and other doc groups are voicing opposition to rebranding physician assistants as “associates,” concerned the move could cause confusion among patients.
Late last month, the American Academy of PAs House of Delegates passed a resolution, officially designating “physician associate” as the profession’s preferred term. The 198-68 vote followed hours of deliberation and years of study by an international marketing and communications firm, according to an announcement.
ACR, the American Medical Association, and the American Osteopathic Association, however, are against the decision.
“The physician assistant title accurately reflects the training of these professionals and their role in any physician-led team. Any change would lead to confusion among patients as they make important healthcare choices,” the college said Monday, June 7. “Radiologists are uniquely trained and qualified—even among physicians—to provide radiologic care. The ACR actively opposes supervision or interpretation of radiological exams or procedures by nonphysician providers,” it said, adding that it supports the role of the registered radiology assistant—which does not include imaging interpretation or supervision.
In its own statement, the American Medical Association said the name change is “clearly an attempt” to move the PA profession toward independent practice. They’re prepared to work with other medical societies to thwart adding this new verbiage into state or federal policy.
“Given the existing difficulty many patients experience in identifying who is or is not a physician, it is important to provide patients with more transparency and clarity in who is providing their care, not more confusion,” the nation’s largest doc group said June 3.
The American Academy of PAs said its board will now begin discussions to implement this name change. They urged members to hold off until the new title is incorporated into legislation.
To read more, go to Radiology Business.
Learn more about what Zotec Partners can do for your radiology practice here.
