Despite a recession, reimbursement issues, and controversial recommendations about mammography, imaging centers and private practices are managing to survive.

I just received a friendly reminder letter from a small, Manhattan-based radiology practice telling me I’m due soon for my annual mammogram. They’ve been in business for 45 years, have four full-time board-certified radiologists on staff, and are accredited by the American College of Radiology in six modalities. The letter closes on an upbeat note, “We are pleased to announce that we offer full field digital mammography, breast MRI, and MRI guided biopsy to complement our women’s imaging practice.” Despite the cheery tone, all I could think was, I hope they can continue to offer those services.

Radiology practices and imaging centers have had a tough go of it over the past several years. First, there was the Deficit Reduction Act of 2005. Add to that rising technology costs, mounting competition, and more reimbursement cuts. Then, in late October 2009, CMS raised utilization expectations for imaging equipment costing more than $1 million from 50% to 90%. Talk about testing your mettle.

Getting back to mammography for a moment, you have to wonder how women’s imaging centers are managing to make ends meet. With low reimbursement and expensive malpractice insurance, mammography has long been viewed as a loss leader. To stay profitable, centers that provide mammography typically offer other imaging services like CT, MR, and PET. But with higher utilization expectations for these pricey modalities, they may no longer be able to do so.

To make matters worse, the US Preventive Services Task Force (USPSTF) issued its recommendations to raise the mammography screening age from 40 to 50, unless a woman 40 to 49 is at high risk for breast cancer. Putting patient care concerns aside for a moment and looking at this from a purely economic standpoint, the “recommendations” could be yet another blow to imaging centers that provide mammography. It’s too early to tell, but some primary care physicians and GYNs could be swayed, and may simply stop referring women in their forties for mammograms. What’s more, women themselves may take the recommendations to heart and decide to skip their screening.

Yet in spite of the pressures and pitfalls, somehow free-standing imaging centers are still standing. And private radiology practices—like the one I mentioned—are still productive and proud.

It’s a new year. Time for fresh starts and forward-thinking. Imaging centers want to do more than survive, they want to thrive.

That’s why Axis Imaging News is kicking off 2010 with a special section dedicated to imaging centers. You’ll find advice from experts on how to keep your mammography business on track, in spite of the controversial USPSTF recommendations. (See our cover story, “The Mammography Muddle.”) In another article, we focus on the power of technology. Today’s sophisticated PACS solutions are helping imaging centers build referral business, save time, and capture new business. (See “Your PACS, Your Performance.”)

Finally, if your imaging center is not yet accredited, make a resolution to seek accreditation in 2010. You’re going to need it in order to receive reimbursement from CMS for advanced diagnostic imaging services in 2012. Now is the time to prepare. Get your facility accredited by a CMS-designated accrediting organization this year. (See our Last Word column, “Make a Resolution.”) Two years may seem a long time away, but in the meantime, accreditation gives your imaging facility greater credibility with referring clinicians and patients.

Accreditation shows that your imaging center stands for something important—higher patient care and quality. Do it. And stand tall.

Marianne Matthews