Cardiovascular Business - May/June 2008 - (Page 26)

due diligenCe › By Sarah L amBerti SPECT/CT for Cardiac Disease Detection ince its emergence within molecular imaging, SPECT/CT has steadily gained momentum. Early, as well as late adopters now look to the dual modality to create new opportunities for revenue expansion and methods of improving patient care. Still, it can be a hard sell to a group practice or department to purchase a hybrid system because the economic justification for it within nuclear cardiology remains unclear. The marriage of SPECT, which provides functional information, with CT, which provides anatomic data and attenuation correction, is ideal. The hybrid combination helps clarify results, increases diagnostic confidence, and reduces patient callbacks. With better images, the expectation is to cut down on repeated imaging, a source of concern for many payors as well as providers. With the Deficit Reduction Act of 2005, the nuclear medicine market saw a significant drop in 2006 procedure volume as well as sales of SPECT dedicated-cardiac cameras. The North American nuclear medicine market, a once stagnant market, has since started to see growth again and analysts attribute the movement An Economic Conundrum S to increased adoption of SPECT/CT. An analysis from Frost & Sullivan shows that the nuclear medicine market earned revenues in 2007 of $298.4 million. The firm estimates that growth will continue to climb, reaching $325.3 million in 2014. Despite the anticipated growth, SPECT/CT could experience slow clinical adoption due to reimbursement reductions, tight end-user budgets, narrow physician referral bases and low levels of physician education, says Travis Chong, a research analyst at Frost & Sullivan. Know the economic climate As with any major purchase, it’s prudent to conduct due diligence, and in the case of cardiac SPECT/CT, it’s important to research the economic climate. “If four out of five insurers are not going to pay for a SPECT/CT study, then it does not make sense to buy the machine, even if it is good for my patients,” says Stephen Weiss, MD, who operates West Side Cardiology, a private practice in New York, N.Y. Logistically, it probably makes sense to buy a machine that does both SPECT and CT, Weiss says. He has been performing in-house SPECT studies for about nine years, using an upright system from Digirad. “Purchasing a SPECT/CT is not “if SPeCT were to achieve its ultimate potential in economically viable for me based on my resolution and if new SPeCT tracers image focused personal economic climate,” he says. “If I had a practice in which there were no retargets like thrombus in the left imbursement restrictions, then it would atrial appendage or help determine make absolute economic and clinical sense for me to look to SPECT/CT.” if plaque is stable or unstable, then At the heart of the issue are the reimbursement and third-party payor policies the possibility of having a SPeCT/ and the concern over repeated imaging CT scanner might be important for with CT, specifically with layered testing, and, in the process, perhaps under-reimcardiac disease detection.” bursing CT. “If we ignore reimbursement Daniel Berman, mD, director of cardiovascular imaging and insurance coverage issues, then from at Cedars-Sinai medical Center in Los angeles a purely medical perspective, it makes perfect sense to purchase and use SPECT/ 26 Cardiovascular Business May/June 2008

Table of Contents Feed for the Digital Edition of Cardiovascular Business - May/June 2008

Cardiovascular Business - May/June 2008 Contents First Word Cover Story - Coronary CTA: Drafting the Strategic Plan Financing New Technologies: Early Adopters, Lease vs. Purchase, and Joint Ventures Clinical Study Digest: ACE or ARB: It's Your Choice Can Off-Hour D2B Times Be Reduced Without Breaking the Bank? Digital Image Management Primer: Integrating Echo SPECT/CT for Cardiac Disease Detection: An Economic Conundrum Integrating the Healthcare Enterprise Connects IT Systems News & Views Calendar Reader's Resources The Back Page

Cardiovascular Business - May/June 2008

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