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Higher-quality MRIs Raise Questions about Costs and Reimbursement

Scott Wallask, for HealthLeaders Media, July 14, 2009

When the ECRI Institute released its free white paper for the C-suite about hot technologies for 2009, it probably didn't surprise anyone to see electronic medical records top the list.

But the No. 2 ranking from the Plymouth Meeting, PA-based healthcare research firm wasn't as predictable: ultrahigh-field-strength MRIs.

More powerful—and expensive—than standard MRIs, ultrahigh-field-strength models provide higher-quality images that can help better evaluate dementia, multiple sclerosis, head injuries, and muscular disorders, among other ailments.

MRI magnet power is measured by a unit called a Tesla. A lower-strength MRI uses a 1.5 Tesla magnet, while ultrahigh-field-strength MRIs use a 3 Tesla magnet.

"If a 1.5 Tesla MRI is a four-cylinder engine, a 3 Tesla MRI is an eight-cylinder engine," says Tobias Gilk, a leading MRI expert and president at Mednovus, Inc., based in Leucadia, CA. Mednovus develops ferromagnetic detection products for MRI rooms.


Using a time-saving machine

In practical terms, Gilk says hospitals can use 3 Tesla MRIs to:

  • Produce higher-quality images for the same scanning duration as a 1.5 Tesla machine

  • Create images comparable to 1.5 Tesla MRIs in quality in considerably less time, thus increasing the amount of patients who can be scanned

Ultrahigh-field-strength MRIs received prominent ranking in the ECRI Institute's white paper because its experts were receiving plenty of questions about the technology from hospitals and health plans, says Diane Robertson, director of the firm's health technology assessment information service.

The white paper, which HealthLeaders Media first reported on in May, is as much about financial prudence as it is hot technologies.

"I think the overall message for CEOs is they have to think not only twice, but three or four times before they acquire and implement any new technology," Robertson says.

The bottom line? For many hospitals with limited capital funds these days, it will be unlikely they can purchase a 3 Tesla machine for a new or replacement MRI system, according to the white paper.

A 3 Tesla MRI costs from $1.9–$2.5 million, compared to the $1–$1.5 million cost of a 1.5 Tesla model, Gilk says.

Wading into reimbursement muck

There are also reimbursement concerns, though such discussions can muddy, Gilk adds.

The Centers for Medicare & Medicaid Services generally will reimburse MRI exams for the same amount of money, regardless of the type of magnet used, though the reimbursement rates may vary by state, Gilk said.

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