Blue Cross Blue Shield (BCBS) of Massachusetts announced they will give “preference” to freestanding imaging clinics over hospital-based centers through its split-level cost-sharing for x-ray and advanced imaging program effective Jan. 1, 2019.
Once a patient meets their deductible, imaging received at freestanding centers will be subject to lower co-insurance and co-payments. At the same time, higher co-payments will be required for imaging received in the hospital. The payment structure will apply to all Merged Market medical plans except Blue Options plans, Blue Select plans, Connector plans and plans with Hospital Choice Cost Sharing.
The new program will promote the use of lower-cost, high-quality providers, according to BCBS Massachusetts. However, the American College of Radiology (ACR) is concerned the change will impact patient access to care, especially in areas where independent imaging clinics are scarce, according to an ACR release.
The ACR plans to discuss their concerns with the insurer, the release stated.