ACC is moving to rein in the cost of medical scans, which has blown out to $97m in the last year.
‘The cost of these scans (MRI, CT etc) has risen 120 percent in five years. That’s a far greater rise than you would expect from inflation, claim numbers or any other factor’ said ACC Director of Health Purchasing, Gail Kettle.
‘Our analysis found not only that we had been paying for scans that were not injury related but also that the price had been too high.’
‘There is no doubt that scanning is a valuable diagnostic tool. But in addition to the rapid rise in costs, we know that not all scans currently being funded by ACC relate directly to a covered injury. Too many are being done, and they’re too expensive. The point is that every dollar that’s spent inappropriately on scanning is a dollar that could have been spent on a genuine ACC need.’
ACC is therefore planning to reintroduce an earlier system of prior approval of some scans. Since prior approval was dropped in 2004, the number of scans carried out has grown by 20 percent a year. This change will happen some time after July2010.
But that will only address the volume question. So from 1December2009 ACC will also progressively lower the prices it pays to radiologists and other providers of High-Tech Imaging (HTI) scans, such as MRI and CT scans. By August2010 a 20% price reduction will have been achieved. That will bring NZ more into line with the Australian situation.
‘We talked to HTI providers and obviously they’re not happy about a price cut but we believe the new pricing model more accurately reflects the cost of providing the service. The new pricing model was also validated by Deloitte.’
‘Everyone who is entitled to an ACC-funded scan will continue to get one’ said Gail Kettle.
Important note:
This change does not affect urgent or acute scans that need to be done immediately at public hospitals.