Feature | April 10, 2013

New study find Medicare estimates of potential work savings are greatly exaggerated


April 10, 2013 — According to a new study published online in the Journal of the American College of Radiology, any efficiencies in physician interpretation and diagnosis gained when different providers interpret different medical imaging scans performed on the same patient are minute and vary by procedure.

Specifically, no potential intra-service work duplication was found when different exam interpretations were rendered by different physicians in the same group practice. Small potential efficiencies were found possible regarding pre- and post-service activities. Across all modalities, this corresponds to a maximum Medicare professional component physician fee reduction of only 0.95 percent to 1.87 percent for services regarding the same type of scan. For services from different modalities, potential duplications were too small to even quantify.

This issue is debated in health policy circles because the Centers for Medicare and Medicaid Services (CMS) recently enacted a 25 percent Multiple Procedure Payment Reduction to Medicare reimbursement for interpretation of advanced diagnostic imaging scans performed on the same patient in the same session. This reduction applies across all physicians in a group or practice. It does not affect the number of scans ordered, only interpretation of scans already performed. This type of reduction has recently been expanded to physical therapy, cardiovascular and ophthalmology technical services as well. 

“These findings are important because the exams affected are primarily used to care for the most sick or injured patients — those with massive head and body trauma, stroke or widespread cancer. These people often require interpretations by different doctors to survive. This study shows that the data Medicare used to justify funding cuts was inflated by 1,200 percent and not reflective of clinical practice,” said Geraldine McGinty, M.D., chair of the American College of Radiology Commission on Economics.

Because each imaging study produces a set of images requiring individual interpretation, a physician is ethically and professionally obligated to expend the same time and effort, regardless of the date or time of service. Studies show that medical imaging use and imaging costs are down significantly since 2006.

 “While potential efficiencies exist in physician pre- and post-service work when same-session, same-modality imaging services are rendered by different physicians in the same group practice, these are relatively minuscule, and have been grossly overestimated. These findings support the need for greater transparency and methodological rigor when healthcare regulatory actions are taken,” said McGinty.

For more information: www.acr.org

 

 


Related Content

News | Artificial Intelligence

Dec. 1, 2025 — Researchers at the University of California, Berkeley and University of California, San Francisco have ...

Time December 10, 2025
arrow
News | Computed Tomography (CT)

A new study shows large increases in the use of computed tomography (CT) scans of the head in emergency departments ...

Time December 05, 2025
arrow
News | X-Ray

Dec. 1, 2025 – Zwanger-Pesiri Radiology, one of the most respected and technologically advanced outpatient radiology ...

Time December 03, 2025
arrow
News | FDA

Nov. 26, 2025 — a2z Radiology AI has received U.S. FDA clearance for a2z-Unified-Triage, a single device that flags and ...

Time December 03, 2025
arrow
News | Interventional Radiology

Dec. 1, 2025 — GE HealthCare has unveiled the Allia Moveo,1 an image guiding solution designed to enhance mobility and ...

Time December 02, 2025
arrow
News | Archive Cloud Storage

Nov. 30, 2025 — Gradient Health, Inc. has released Atlas 2, a major upgrade to its self-service medical imaging data ...

Time December 01, 2025
arrow
News | RSNA 2025

Nov. 13, 2025 — Nano-X Imaging Ltd., a medical imaging technology company, will showcase its Nanox.ARC X multi-source ...

Time November 25, 2025
arrow
News | Artificial Intelligence

Nov. 24, 2025 — Siemens Healthineers is launching artificial intelligence-enabled services to help healthcare providers ...

Time November 24, 2025
arrow
News | Artificial Intelligence

Nov. 20, 2025 — Aidoc has announced a collaboration with AdventHealth to launch one of the largest imaging AI ...

Time November 21, 2025
arrow
News | Radiology Business

Nov. 13, 2025 — Covera Health recently announced that Advanced Radiology Services (ARS) has joined its national Quality ...

Time November 17, 2025
arrow
Subscribe Now