RESTON, VA — The new Anthem cost-cutting policy of not covering computed tomography (CT) and magnetic resonance imaging (MRI) performed in hospital outpatient departments is arbitrary and unwise.
Economically motivated steerage of patients compromises the physician-patient relationship and undercuts integrated health care efforts.
Denying patients covered access to care at such a vast number of facilities will delay care, increase wait times and force many patients to travel outside of their communities to get advanced imaging.
The policy may particularly impact patients in inner city and rural areas. In many areas, the local hospital outpatient setting may be the only immediate access point for advanced imaging outside of the main hospital.
The ACR is concerned that Anthem's policy will force patients to locate an ever-declining number of freestanding imaging centers and/or physician’s offices to access imaging services.
If patients do find local, freestanding imaging centers, such facilities may not be immediately prepared to care for an influx of patients now denied covered access to hospital outpatient imaging. Also, by steering all patients out of the hospital, odds of these facilities caring for a patient that may experience complications is increased.
Forcing all advanced imaging out of hospital outpatient departments may prompt many of these facilities to cut back on standard imaging (X-ray, etc.) or close altogether. This may be particularly true in areas where hospitals care for many indigent patients.
Moreover, this policy will impact negatively the ability to train the next generation of radiologists. The preponderance of radiology training programs occur in hospitals and hospital-owned imaging facilities.
While the new Anthem policy may save the company money in the short term, patients will pay the price through decreased access, longer wait times and longer commutes to receive care. Health care reform will also be slowed or even rolled back.
We urge Anthem to reconsider their approach and work with providers and hospitals to achieve better coverage policy.
About the American College of Radiology
The American College of Radiology (ACR), founded in 1924, is a professional medical society dedicated to serving patients and society by empowering radiology professionals to advance the practice, science and professions of radiological care.