News | July 30, 2012

ACR: Medical Imaging Study Potentially Misleading

July 30, 2012 — A study (Lee and Levy) published in the August issue of Health Affairs reconfirms results of previous studies that imaging use in Medicare is down significantly over the last several years (Moran Report) and that imaging is among the slowest growing of all physician services among privately insured Americans (Health Care Cost Institute). However, the list of factors cited for this decline is incomplete and the drop in imaging use is not without adverse consequences.

Imaging utilization has tightened due to a number of factors, including greater use of evidence-based American College of Radiology (ACR) Appropriateness Criteria and electronic physician order entry systems based on these guidelines, which ensure that patients get the right scan for the right indication. These tools have been shown to improve quality, reduce unnecessary scans and lower imaging costs. Efforts such as Image Gently and Image Wisely have made providers aware of opportunities to reduce radiation from imaging exams and reduce unnecessary use of scans. In addition, increasing numbers of imaging facilities are becoming ACR-accredited, which helps improve quality and reduce duplicate scanning due to poor-quality images. These efforts have undoubtedly contributed to lower utilization.

A study recently published in the Journal of the American Medical Association (JAMA) shows similar utilization patterns (down in recent years) in integrated healthcare systems, as well as fee-for-service settings, meaning reimbursement has little to do with physician ordering decisions. However, the imaging cuts have, in fact, damaged patient care. For example, a December 2011 study in Health Affairs found that as many as 12,000 American seniors may have suffered broken bones due to Medicare cuts in reimbursement for just one type of imaging scan (dual energy X-ray absorptiometry, or “DEXA”). This is only one example of detrimental effects of more than $5 billion in Medicare imaging cuts since 2005.

These drastic cuts are causing imaging providers to cut back or close services, says the ACR. According to the U.S. Food and Drug Administration (FDA), there are now 207 fewer mammography facilities and nearly 1,200 fewer mammography scanners available to American women than in January 2007. These cuts and closures are forcing seniors to commute further and wait longer to receive care, and may force seniors to pay more out of pocket in co-pays as imaging access retreats to the larger hospital setting, where care is more expensive.

Various studies show that imaging exams are directly linked to greater life expectancy and for many indications, declines in mortality rates. Scans are also safer and less expensive than many of the invasive procedures they replace. For many serious indications, imaging exams reduce the number of invasive surgeries, unnecessary hospital admissions and length of hospital stays. Although radiology benefits managers (RBMs) have been used in the private sector for 10 years, there has been no scientific, peer-reviewed research on their safety or impact on administrative costs. In fact, a Patient Advocate Foundation (PAF) report found that insurance coverage denials to patients seeking critical imaging services have doubled over the last four years, while 90 percent of the reversed denials for imaging services were actually covered in health plan language.

“This Health Affairs study further supports the fact that medical imaging scans are being more efficiently used and are not a primary driver of rising healthcare costs. Medicare spends the same amount on imaging services now as in 2003—virtually unheard of in the healthcare arena. This is likely the case among the privately insured as well. Those who contend that imaging is primarily responsible for rising costs are either misinformed or purposefully misinforming others. RBMs deny needed care and intrude on the doctor-patient relationship at critical times. Arbitrary, backward-looking limits on care may slow or even reverse gains against cancers and other serious illnesses and deny patients access to potentially lifesaving services,” said Paul Ellenbogen, M.D., FACR, chair of the ACR Board of Chancellors.

For more information:

Related Content

News | Imaging | September 18, 2017
Mary Washington Hospital and Union Health-Union Hospital will both receive Safety FiRsT grants to implement safety...
Understanding True Patient-centered Care in Radiology
Sponsored Content | Whitepapers | Imaging | September 18, 2017
What is the true meaning of “patient-centered care”?
ASRT Donating $10,000 in Support of Hurricane Irma Relief Efforts
News | Business | September 12, 2017
September 12, 2017 — The American Society of Radiologic Technologists (ASRT) announced it will donate $10,000 to the
News | Imaging | September 11, 2017
September 11, 2017 — Innovatus Imaging Corp., a newly created holding company formed by private equity firm Resilienc
DoseWise is Philips' automated dose management platform

DoseWise is Philips' automated dose management platform.

Sponsored Content | Case Study | Radiation Dose Management | September 08, 2017 | By Kelly Golkin
Continuing education and training are essential in the healthcare industry. Physicians are required to earn a certain...
The GE Healthcare Signa Premier MRI was among the top radiology stories from August 2017

The GE Healthcare Signa Premier MRI was among the top radiology stories from August 2017.

Feature | Imaging | September 01, 2017 | Melinda Taschetta-Millane
Here is the list of the most popular articles and videos on the Imaging Technology News (ITN) magazine website from the...
Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Imaging | August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
Patient Complexity, Subspecialization Impact List Prices for Radiologists' Services
News | Business | August 15, 2017
A new study by the Harvey L. Neiman Health Policy Institute finds that patient condition complexity and...
Upcoming radiology conferences, meetings and events.
News | August 14, 2017
ITN maintains a comprehensive listing of radiology specialty meetings on its website at ...
Overlay Init