FRITZSCHE ASSUMES RSNA PRESIDENCY; SUCCESSOR, BOARD CHAIR, NEW MEMBER NAMED

Peggy J. Fritzsche, MD

Peggy J. Fritzsche, MD, was installed as? president of the Radiological Society of North America during the 88th annual society meeting in Chicago on December 5, 2002. Fritzsche, a member of the RSNA board of directors since 1995, played a pivotal role in expanding RSNA’s public information efforts, including the radiology exhibit at Walt Disney World’s EPCOT? center. Currently medical director at Riverside MRI Center in Riverside, Calif, and at San Bernardino Comprehensive Medical Imaging and Inland Empire Regional PET Center, Fritzsche is clinical professor of radiology at Loma Linda University School of Medicine, where she has served on the faculty for 30 years. She has authored more than 50 journal articles and book chapters and was the primary author of the Raven MRI Teaching File, MRI of the Body, in 1993. A long-standing member of the Decisions in Axis Imaging News editorial advisory board, Fritzsche has served on the editorial board of several journals, including Radiographics. She is the second woman to serve as president in the society’s history. Helen Redman, MD, was the first woman to serve as RSNA president in 1995.

(Brian C. Lentle, MD

Fritzsche’s successor, Brian C. Lentle, MD, was installed as president-elect. Lentle, a board member since 1998, is professor emeritus of the Department of Radiology at the University of British Columbia, and recently served two terms as radiology department chairman at Vancouver General Hospital. He has written more than 130 peer-reviewed articles and 17 book chapters, and his areas of interest and expertise include nuclear medicine, radiology, osteoporosis, and the history of medicine.

Hedvig Hricak, MD, PhD

Additional appointments included the naming of David H. Hussey, MD, as chairman of the RSNA Board of Directors. He is currently clinical professor in the Department of Radiation Oncology at the University of Texas Health Science Center in San Antonio. Hussey has served as president of the American Radium Society, the American Society for Therapeutic Radiology and Oncology, and the Gilbert H. Fletcher Society. Also, Hedvig Hricak, MD, PhD, was elected to a 6-year term on the RSNA board of directors. Hricak, author of 265 articles and 131 book chapters, is chairman of the Department of Radiology at the Memorial Sloan-Kettering Cancer Center in New York City.

GROWTH PREDICTED IN MOBILE MRI, CT, AND PET MARKETS

Frost & Sullivan, a San Antonio, Tex-based consulting firm, has published a new market analysis that says the combined mobile MRI-CT-PET market was expected to reach $686 million in sales revenues at the end of 2002. And the firm predicts that figure will jump to over $1 billion by 2006.

Here are some of the findings of the North American Mobile Imaging Equipment Markets analysis:

  • A combination of low or sporadic procedure volumes at many facilities, geographically dispersed populations, and limited capital equipment budgets has made shared mobile imaging services a growing trend for many small and medium imaging operations.
  • The expense of new technological advancements in equipment is making it difficult for facilities to own the latest equipment.
  • The growing size and opportunity in the mobile services market are sparking interest among modality vendors: dominant multi-modality manufacturers are becoming more aware of revenue projections for mobile imaging, and considering expansion in the service management and coach segments, traditionally owned by independent contractors and regional operators.
  • The growing competition to provide mobile imaging units to medical facilities is speeding the growth of value-added services as adjunctive features. In attempts to attract and retain client facilities, providers are branching into electronic over-read services, physician education/training, and reimbursement and business management advice. The report recommends that providers focus on rural, semirural, and suburban community hospitals, which are the regions with the highest mobile imaging potential.
Total market revenue forecast for mobile MRI, CT, and PET equipment sales, which was $583 million in 2001.

SENATE RESOLUTION WILL FREEZE PHYSICIAN FEE CUTS

The Senate, as part of its omnibus fiscal year 2003 appropriations package, has passed a resolution that will stop Medicare physician payment cuts from taking effect in March. The measure, House Joint Resolution 2 (HJ Res 2), stipulates that Medicare payments to physicians remain at 2002 levels until September 30. It strikes the 2003 conversion factor from the law and replaces it with the 2002 conversion factor. The Congressional Budget Office estimated the cost at $800 million. The House of Representatives is in recess until January 27 and must conference its appropriations bill with this Senate legislation before final passage.

A final rule by the Centers for Medicare & Medicaid Services cut physician payments by 4.4%, starting March 1. In addition to relief for physicians, the Senate’s provision contains a 6-month funding addition for rural and small urban hospitals that would raise the inpatient base rate to that of large urban areas.

HEALTH CARE’S RISING SHARE OF GDP OWED TO ECONOMY STALL

A newly published study says that an increase last year in health care’s share of the gross domestic product (GDP) owes more to the country’s economic slowdown than to health spending increases. The article, by Katharine Levit, director of the National Health Statistics Group, Office of the Actuary, Centers for Medicare & Medicaid Services (CMS), notes that US health care spending grew 8.7% in 2001, to a total of $1.4 trillion, while the health share of GDP increased sharply from 13.3% in 2000 to 14.1% in 2001.

The recession, which economists say began in March 2001 and worsened with the September 11 terrorist attacks, led to slower economic growth. During this period, according to Levit, health spending increased 1.3 percentage points, while economic activity decelerated 3.3 percentage points. Levit shows that total public funding grew 9.4% in 2001, exceeding private funding growth by 1.2 percentage points. This increase was due in part to increased Medicaid spending because of the recession, says Levit, as well as payment increases for Medicare providers. Other findings:

  • Private health insurance premium growth increased for the fourth consecutive year. Premiums rose 10.5% in 2001, and benefits grew 10.1% with a slight increase in net cost of private health insurance (difference between premiums and benefits) from 11.2% in 1999 to 11.9% in 2001.
  • Spending on physician and other clinical services increased 8.6% in 2001, to a total of $313.6 billion. This figure marked the second year of growth in physician spending. This growth might be linked to growth in imaging procedures, and was reflected in an increased rate of growth in aggregate work hours in physicians’ offices, from 3.0% in 2000 to 4.4% in 2001.
  • Hospital spending increased 8.3% in 2001, its fastest growth since 1991.

Levit concludes by noticing that historically, large increases in the health share of GDP have led to private initiatives or public policy changes that slowed the pace of health spending growth. As health care costs rise, consumers may be asked to contribute more toward existing coverage, or choice of plans, providers, and benefits might be pared down.

NCQDIS MEMBERS TO TACKLE COST SURVEY

About 50 members of the National Coalition for Quality Diagnostic Imaging Services (NCQDIS) gathered at the a restaurant in Chicago on December 3, to hear Washington, DC-based Powers, Pyles, Sutter & Verville attorney and NCQDIS legal counsel Diane Millman discuss the legislative and regulatory changes affecting diagnostic imaging. There was good news, bad news, and, ultimately, a consensus that the NCQDIS should undertake a survey to accurately determine the cost of delivering radiology services.

While Congress failed to act in 2002 to reverse the automatic 4.4% reduction in the conversion factor used to arrive at payment under the Physician Fee Schedule for 2003, a significant increase in the practice expense RVUs for technical component services will increase total global RVUs for many diagnostic imaging services by approximately 4%, Millman said. Rates for most MRI and CT procedures will increase, but echocardiography payments will decrease significantly. Payment for most radiopharmaceuticals have been included in the Ambulatory Payment Classification rates for nuclear medicine procedures, and most pass-throughs have been eliminated. While PET reimbursement was preserved at its current rate, further attempts to roll back reimbursement are anticipated.

NCQDIS president Cherrill Farnsworth reported that earlier in 2002, Centers for Medicare & Medicaid Services (CMS) determined that diagnostic radiologists cannot order contrast if they think it is indicated, but interventional radiologists can. “We have to raise the profile of radiologists with Congress, we have to look at PET, and we have to look at CTA and MRA,” she said. “If we don’t get aggressive about it, shame on us. We gave it away.”

And while CMS has indicated that it does not like the methodology currently used to determine the technical component of the Physician Fee Schedule, Millman said, it has indicated that it would be methodologically correct to mix data from freestanding imaging centers and hospital-based radiology. NCQDIS has committed to undertaking its own cost-based accounting of radiology services at freestanding sites to contribute to the data pool available to CMS for determining the technical component of the Physician Fee Schedule. NCQDIS is a nonprofit advocacy organization composed of radiology administrators, radiologists, and vendor representatives. For information on how to become a member, contact Sheila Gell at (202) 872-6767.

LOW RISK FOR LOW-LEVEL RADIATION?

A review in the November 2002 edition of the American Journal of Roentgenology (AJR) suggests that the cancer risk from low-level radiation is grossly exaggerated.

The review’s lead author, Bernard Cohen, PhD, University of Pittsburgh, says that recent research does not support the linear no-threshold theory, which states that any level of radiation exposure automatically increases the chances of developing cancer. On the contrary, Cohen says, “substantial evidence exists that low-level radiation may even be protective against cancer.”

Cohen also writes that studies undertaken in the last 10 years have shown that low levels of radiation trigger various processes that protect against cancer’s development. These processes include stimulating the immune system, increasing the body’s production of enzymes that fix cell damage, extending the cell division time period, and increasing the amount of apoptosis (suicide) of cancer-ridden cells.

Cohen points to the “substantial” data that he reviewed that indicate that the latent period between radiation exposure and cancer death increases with decreasing exposure. “These data lead to the obvious conclusion that for low-enough exposures, the latent period exceeds the normal life span, so no actual cancers develop,” he writes.

Cohen claims that his findings will save hundreds of billions of dollars in radioactive waste management, as well as alleviate public fear of radiation.

INDUSTRY NEWS

GE Medical Systems, Waukesha, Wis, has acquired Ambassador Medical Inc, Carmel, Ind, a supplier of preowned ultrasound equipment. GE plans to establish a Center of Excellence for refurbished ultrasound equipment at Ambassador’s Carmel facility. In addition, GE has entered into a definitive combination agreement to acquire Instrumentarium, Helsinki, Finland…IMCO Technologies, Pewaukee, Wis, has entered into an agreement with Vision Imaging Partners. Under the terms of the agreement, the family of PACS products manufactured and supplied by IMCO will be available to Vision Imaging Partners…National Imaging Resources (NIR), Willoughby, Ohio, and InfiMed Inc, Liverpool, NY, have signed an agreement to allow NIR to private-label InfiMed’s flat-panel digital radiography systems…RealTimeImage, San Bruno, Calif, has announced a licensing agreement with HX Technologies, Morristown, NJ, a developer of secure network solutions for cross-institutional integration of medical care…Camtronics Medical Systems Ltd, Hartland, Wis, has been named a certified partner of Millbrook Corp, Carrollton, Tex. Camtronics will integrate its Vericis? CardioWorks? electronic medical record system with Millbrook’s Practice Manager? system…TeraMEDICA Inc, Milwaukee, has been selected as a winner of the 2002 eInnovate “Technical Knock-Out” award, presented to the company for its Intelligent Image Management Technology…Precyse Solutions, King of Prussia, Pa, a health information management services company, has signed an agreement to acquire the health information services division of QuadraMed Corp, Englewood, Colo, a company specializing in coding compliance and education services…Agfa HealthCare, Mortsel, Belgium, has signed a co-marketing agreement with AccessPt. Inc, Jackson, Miss, a software company that develops products that deliver data and information from multiple, disparate, back-end hospital systems and presents it to the user with one common view via a browser. In addition, Agfa has announced that it is integrating its IMPAX? PACS offering with EMC Corp’s Centera? content addressed storage solution. Agfa has also signed an agreement with Siemens Medical Solutions, Malvern, Pa. Under the terms of this agreement, Agfa will provide its CR, dry imager, and film handling systems to Siemens…VitalWorks Inc, Ridgefield, Conn, has received certification from Claredi Corp, Salt Lake City, a provider of HIPAA compliance testing and certification services, for professional claim transactions generated by VitalWorks’ current product offerings…Richardson Electronics, LaFox, Ill, a provider of engineered solutions for the medical display systems market, has been named an authorized distributor for Planar Systems, Portland, Ore, a company specializing in flat-panel medical display solutions…Voxar, Edinburgh, Scotland, a 3D medical imaging company specializing in PACS, has opened a new North American headquarters in Boston. Voxar’s American operations are now managed from this location…The American College of Radiology, Reston, Va, has been elected to the 2003 Associations Advance America Honor Roll in recognition of its diagnostic and radiation oncology accreditations program. The annual awards competition is sponsored by the American Society of Association Executives, and recognizes associations that develop innovative projects in the areas of education, skills training, and community service.