Anthem's New Outpatient Imaging Policy Likely to Hit Hospitals' Bottom Line

Navigant's Rich Bajner via Modern Healthcare

In what may be the first strike in a battle over what healthcare services should be provided in a hospital, Blues giant Anthem will no longer pay for MRIs and CT scans performed on an outpatient basis in hospitals across the country.

As healthcare costs continue to rise, Indianapolis-based Anthem, which is run by a former health system CEO, is taking aim at a service that can be far more expensive in a hospital than in a free-standing imaging center.

The service boosts hospitals' income, with some health systems collecting more than half of their profit from imaging services, according to Rich Bajner, a managing director at Navigant. So it's not surprising that hospital executives in the states affected by Anthem's policy are worried about their bottom lines being squeezed at a time when they are already dealing with lower patient volume and razor-thin margins.

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