ACC likely to hit patients with scan fees

The rocketing bill for MRI and other high-tech imaging has set alarm bells ringing at ACC headquarters. Photo / BOP Times

Injury victims may have to pay part of the nearly-$1000 fee for high-tech scans under cost-cutting proposals by the state-owned accident insurer.

The Accident Compensation Corporation is under pressure from the Government to deliver better value for money and is undertaking a wide-ranging "stocktake" of its operations and funding.

It is trimming staff numbers and ending a free physiotherapy scheme after ACC Minister Nick Smith said the costs were "out of control". ACC claimants on physio will now have to contribute.

Now officials want to rein in the increasing number of high-tech scans of claimants.

The corporation is alarmed by year-on-year increases of 20 per cent in ACC's spending on such scans, of which most goes on magnetic resonance imaging (MRI) and some on computed tomography (CT) scans.

The bill is expected to reach $60 million this financial year, according to a discussion document issued last month.

The reasons for the rapid growth of MRI scanning include that is non-invasive, very effective and is credited - because of earlier diagnosis and therefore treatment - with speeding up the recovery of many patients.

Also, the kinds of specialists who can order ACC-funded MRI scans have expanded beyond just orthopaedic surgeons and, in some cases, ACC requires an MRI diagnosis before agreeing to pay for surgery.

New Zealand has around 40 MRI machines. They can cost up to $4 million.

Under current rules, radiology providers cannot charge co-payments from ACC claimants for high-tech imaging. They can charge for other images such as x-rays, which can cost patients a top-up of $20 for a straightforward picture, although fees vary.

Radiologists in the MRI business, their transtasman professional college and the Orthopaedic Association have serious concerns about many of the proposed changes, but are relaxed about patient co-payments.

"That is something that happens in a lot of imaging. We wouldn't have a problem with that," said Mark Leadbitter of Wellington, chairman of the college's NZ branch.

ACC's director of clinical services, Dr Kevin Morris, said no conclusion had been reached on the level of patient co-payments.

The discussion document also flags a restriction on the number of radiology groups ACC will pay for scans, and greater efforts to screen out those suffering from degenerative conditions rather than injuries. But it asserts a commitment to improving quality.

Dr Leadbitter said college members would accept a price cut because of the general downturn in the economy and ACC's financial pressures, but they feared some of the changes would erode the quality of high-tech imaging and force more radiologists - already in short supply in New Zealand - overseas.

"If they want a budget service, that's what you will get. If they drive prices down by a process that incentivises people to cut corners and potentially encouraging people to produce lesser-quality imaging, we certainly wouldn't support that."