June 4, 2012
It’s amazing how far ultrasound has come. First it was 3D, then 4D, and now we have 3D parametric mapping. But what are we getting for all the new advancements? Ultrasound in general is a remarkable technology. It offers safety and accuracy at a cost much lower than other high-end imaging technologies. 3D parametric imaging construction offers physicians excellent detail of the heart’s function in an easy-to-read format.
As with any new technology, there is a price tag. But now, with value a key word in buying, you have to put costs in perspective. A high-end ultrasound machine costs in the $200,000 plus range. 3D parametric mapping may add $8,000 to $15,000, depending on your needs. If you’re considering other cardiology imaging technologies that can perform flow and mitral valve studies, the price range starts at more than twice the amount. So cost-wise, ultrasound appears to be a bargain.
To help account for a rapidly evolving technology, CMS has increased the payment level for Echo Transesophageal Studies (APC 270) from $60 in the last three years to $590. This is on par with CT or MRI – two technologies that start at $1 million each. The downside is, unlike PET, CT, or MRI, there is no add-on payment for an ultrasound 3D image. Still, under APC 270, there should be room for hospitals to make their margins.
Taking the lead from The Agency for Healthcare Research and Quality’s (AHRQ) Effective Health Care (EHC) Program shows us that cost isn’t everything. How effective a technology is plays a big part. As for outcomes, one recent study I found reflected a 5% improvement in diagnostic accuracy when cardiologists used 3D parametric maps as compared to 2D transesophageal echocardiography (87% verse 92%). According to the study, this improvement is because 3D parametric images allow for a simpler image to view.
3D parametric images cost around $4 to $6 per study for a 5% improvement in diagnostic accuracy. Sounds like a bargain to me. I will look at this again when 4D parametric imaging comes into play. The studies could be interesting.