One of the most effective tools available to doctors in screening patients for common medical issues is imaging – ultrasound, x-ray and mammogram. With a simple radiological image, doctors can diagnose or render preventive and primary medical care, avoid emergency department visits and hospitalizations.
Yet, as the nation is moving towards making health insurance more available and affordable, the state of Connecticut cut reimbursements to radiology providers for Medicaid payments by 42.5 percent last year, and this year are looking to make that cut permanent.
And at a time when regular mammograms have become the accepted standard of care for preventing breast cancer deaths, the state has taken a step backwards with budget cuts.
The reductions target only private practice radiologists, not hospitals or hospital-employed physicians. Under the current reimbursement methodology, for example, a medical office is reimbursed six dollars for a chest x-ray. The new rates are already having an impact on access to care, and will eventually limit access to imaging services for every individual in the state.
In Meriden, a private practice has announced it will no longer accept new Medicaid patients. And last July, one of only two private practices in Hartford closed, leaving patients with a single private practice and hospitals as their only options.
If the cuts are made permanent, Medicaid patient will have few, if any non-hospital providers who will accept their insurance, forcing them to go to hospitals for routine outpatient and screening exams, at a higher cost and far less convenience.
With more patients forced into fewer radiology practices, access for every patient across the state will ultimately be affected.
Meanwhile, the American Cancer Society estimates that approximately 21,700 Connecticut residents will be diagnosed with cancer in 2016, and 6,780 will die from the disease.
While the state claims that the rates are in line with neighboring New England states, that is simply not true. Connecticut’s Medicaid reimbursement rates for radiology are among the lowest in the country, on par with only a few other states such as Mississippi.
Radiology differs from many other medical specialties in the private practice setting because of the very expensive capitol costs in imaging equipment and technology required. Decisions to turn away patients and close offices are not easily undone. Because of that, many private practices remain hopeful that the cut to Connecticut’s reimbursement can be restored.
In difficult economic times, the General Assembly is faced with many difficult choices, to be sure. But limiting access to diagnostic tools and health care for patients is the wrong direction for Connecticut to be headed in.
If the cuts are not restored, we will see more radiology practices close, and a narrowing and erosion of access to care for Connecticut’s most vulnerable patients. The state should be adopting policies and budgets that make imaging and preventive care more accessible, not limiting access.
David Klein, M.D., practices at the Norwalk Radiology and Mammography Center.