Time Capsule 2013
We all have important items that we would
put into a proverbial chest of timely
mementos. In 10–15 years, I should be well
into retirement before this time capsule is
re-opened. And these imaging items will
probably be the last things on my mind.
Obamacare. This is a BIG item in our
time capsule. With political winds push-
ing it all over the yard, who knows where
this may end up. Some thoughts:
• As much as we may complain about it,
it’s here to stay.
• The technology has glitches. So what’s
new? Tell me about any software
in your workplace that started and
worked perfectly. Any system, no matter how well thought out, has unforeseen problems. It will get better.
• Will the mandatory healthcare insurance requirement have teeth? It was
many years ago that having auto insurance was a legal requirement, yet there
are still plenty of people who don’t
have it. As long as we have emergency
departments, there is no reason for
those without insurance to sign up.
• As confusing as it may be, and as much
political noise as it’s generated, we may
look 10 years down the road and admit
that something had to be done. I am
optimistic that is the case.
Revenue reductions. A time capsule
from 10 years ago would have contained
the same item. Managed care and projected
reductions was eminent, and it was a given
that diagnostic testing would plummet in
order to reduce the high cost of healthcare
delivery. Well, the opposite happened, and
because care is so dependent upon high tech
diagnostics rather than physician examina-
tions, imaging services continue to increase.
• There will be pricing wars, as insurance carriers will be looking to get
diagnostics done by those who choose
to compete on pricing of procedures.
Insurance companies don’t want to
reduce their revenue either, so expect
they will use low cost service providers
and boost deductibles.
• Volumes will potentially level off, as
there is an overabundance of diagnostic testing that is ordered. This is years
in coming with the reality of CYA
medicine, but also because the technology continues to get more definitive.
• Reimbursement will continue to
decrease. More bundling and more
complicated coding requirements will
see to that.
• Purchasing the latest equipment will
be more and more difficult because
the curve for new technologies is too
sharp. Also, the pressure of purchasing newer equipment will increase
because physicians coming out of
learning institutions have high diagnostic expectations.
Reduced healthcare benefits. Companies know that it’s increasingly expensive to provide healthcare to employees.
• More companies will be using health
plans that increase deductibles and will
also charge more to have insurance.
• Employers will find more ways to hire
individuals where healthcare is not
provided. People will need to purchase their own.
• Catastrophic insurance plans will be the
choice of many to keep insurance rates
lower, but to provide protection against
a major illness. Urgent care will boom.
• Emergency departments will still be
the catch all for many who do not have
access to healthcare, nor have the tools
to access systems.
RSNA. I am so thankful that I got to
attend RSNA when it was a blast. With
new rules governing gifting to customers, the day of gala events, extravagant
meals, and expensive expositions are
truly in our past. Certainly, RSNA is a
valuable organization and world wide
educational conference. But the bang for
the buck for vendors that fueled all of the
extravagance is no longer there.
AHRA Annual Meeting. Continued
growth in importance and attention
given to imaging administrators and
their key role in making equipment decisions. As there is great parity in the quality of exams being produced by many
vendors, purchasing decisions will be
what drives growth. Face it, AHRA’ers,
we are now the final decision makers for
high expense purchases. That will be a
good thing for AHRA.
As we close this time capsule, it is my
wish that you all have a healthy and happy
2014. Take good care of yourself.
Gordon Ah Tye, FAHRA is director of imaging and
radiation oncology services for Kaweah Delta Health
Care District in Visalia, CA. He holds a bachelor’s degree
in biological sciences from California State University in
Fresno. Gordon is a past president of AHRA, received the
AHRA Gold Award in 2001, and received the 2006
Minnie for Most Effective Radiology Administrator of the
year. He may be contacted at firstname.lastname@example.org.
By Gordon Ah Tye, FAHRA
on that note