Mammogram Centers Scale Back Services, Creating Delays
Setting up a potential "crisis" in preventive women's health, the nation's mammography centers have been "scaling back" services or even closing in the face of "inadequate" reimbursement rates and "malpractice fears," a panel of physicians said Nov. 29 at the annual meeting of the Radiology Society of North America. The AP/Baltimore Sun reports that mammograms usually range in cost from $75 to $150, and diagnostic tests, which are performed when a problem is suspected, may cost more than $200. However, Medicare reimburses providers "well below" those costs, at $67 and $81, respectively, Mount Sinai Medical Center breast imaging Director Dr. Stephen Feig said. In May, the American College of Radiology sent a letter to HCFA, warning that unless reimbursement rates were raised, many hospitals would limit screening services. Furthermore, malpractice suits also are a concern for mammography centers, as the exams miss between 10% and 20% of cancers. Such fears have led "would-be mammographers to choose other specialties," the panel said.
The panel said "shrinking" access will likely result in "reduced services, longer waits and potentially more cancers detected at less treatable stages." Women have experienced months of delays in seeking breast cancer screening, even those with "suspicious lumps." Those delays might cause some women to skip exams altogether, the AP/Sun reports. According to research, routine mammograms can reduce the risk of breast cancer fatality by as much as 40%, but the inability to schedule an exam might "delay" a cancer diagnosis and thus lead to tumors being found at later, less treatable stages. The American Association of Health Plans, representing more than 1,000 managed care plans and other insurers, said that it "does not see a crisis looming" concerning mammogram access, pointing to figures showing that the number of women over the age of 40 who have had a mammogram in the past two years has more than doubled since 1987. Those figures do not indicate a lack of access, the association maintains (AP/Baltimore Sun, 11/30).