July 24, 2006—In addition to the testimony from health care professionals, Congress heard testimony from several other stakeholders in the radiology field during the hearing to evaluate HR 5704, the Access to Medicare Imaging Act, on Tuesday, July 18.

John Donahue is CEO of National Imaging Associates Inc, a radiology benefits management firm. He spoke of the need for comprehensive benefits management, describing it as “the soundest public policy.”

“The quality, safety, and affordability of diagnostic imaging hinges on three distinct areas: evaluation and ordering of imaging care, delivery of imaging care, and payment of imaging care,” Donahue said. “My firm belief is that ordering, delivery, and payment must be addressed holistically.”

He suggested that benefit management—such as that provided by his firm, which “saves out managed care partners hundreds of millions of dollars per year by eliminating wasteful imaging studies”—be adopted in every Medicare Advantage plan. He also noted that an opportunity exists to develop quality and efficiency standards for imaging while Medicare is moving to the “pay for performance” system.

Robert Baumgartner, CEO of the Center for Diagnostic Imaging, testified on behalf of the National Coalition for Quality Diagnostic Imaging Services (NCQDIS). Noting that NCQDIS is actively involved in recommending criteria to CMS for quality, utilization, and alignment of federal and private standards, Baumgartner agreed that regulation of utilization—not reduction of reimbursement—is the key to lowering imaging-related costs.

Baumgartner’s testimony focused on three specific recommendations:
1) that all providers of diagnostic imaging be required to adopt the same standards as independent diagnostic testing facilities;
2) that the development of quality standards be supported both publicly and privately; and
3) that Congress recognize payment cuts would be ineffectual at reducing utilization.

“Imaging is a vital part of the fabric of today’s medical care,” he said, “and the federal government needs to look for ways to foster its appropriate use and to promote consistent service, and not to stifle its promise.”

—Cat Vasko