What New CMS Cuts Mean for X-ray Film Processing

Well, we all knew this time was coming, some of us just weren’t sure how quickly. Film-based X-ray has been in decline for years, but now it’s looking more like an aging boxer struggling on the ropes in the 12th round. The 2016 Consolidated Appropriations Act (div. O, title V, sec. 502), which became law on 12/18/15, landed a significant body blow to film processing for X-ray. With a 20 percent decrease in reimbursement from CMS for film X-ray in 2017, many providers need to determine in the next six months or so if the transition to a digital detector is feasible for their practice. The other option is to get out of the X-ray business altogether.

In the imaging field, the decision to purchase capital equipment has a lot to do with patient volume. We’ll take a deeper look at some examples below to help illustrate what the time to ROI for upgraded equipment looks like at several volume levels.

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Low-Volume Clinics
Clinics with low volume (50 exams or fewer/month) could take up to three years to begin seeing ROI on a digital detector upgrade for their system. If you operate at that volume, and waiting that long seems daunting, you may want to consider discontinuing X-ray services and refer your imaging.
If you chose to get out of X-ray, there is a trade-off: although reimbursement revenue (or 80 percent of it, as of 1/1/17) would disappear, so would the monthly expense of film and chemicals and maintenance for your processor equipment. There may also be value in your X-ray room itself. This equipment can be sold and revitalized with a digital upgrade.

Moderate-Volume Clinics
Clinics that see a medium number of patients (50-100 exams/month) could easily transition to digital images with a small capital investment in a refurbished CR system. This is a temporary fix, however, as the Consolidated Appropriations Act will begin to cut CR reimbursements as well beginning in 2018.
Upgrading an existing analog X-ray room with a digital detector, while more expensive than CR, is a more long-term solution that is not subject to any reimbursement cuts. At the medium volume level, a clinic could expect to begin seeing ROI from a digital detector upgrade somewhere between 18 and 24 months.

High-Volume Clinics
If your clinic’s volume is 100-150 exams/month, it’s reasonable to forecast the beginning of ROI for a digital detector at 12-18 months. If a clinic operating at this volume has not made the move to DR flat panel detectors, now is the time. Not only will you be able to avoid reimbursement cuts, you’ll also be able to take advantage of the other benefits of digital X-ray, like increased efficiency and image quality.

The Takeaway
Depending on your level of X-ray patient volume, the passage of these new reimbursement cuts is likely to be the punch that finally knocks X-ray film processing out for good. Now, before reimbursement cuts take effect, is the time to begin making your plans for the future of X-ray service at your practice. Upgrading your analog system with a digital detector is, ultimately, one of the more cost-effective ways to do so.

John Maher is the Product Specialist, X-ray for Block Imaging International.