A recent study carried out by change:healthcare has found major price disparities across the country for advanced diagnostic imaging procedures. In some cases, patients may be paying over 700 percent more than others to obtain necessary diagnostic tests.
The study is backed by twelve months of claims from over 150,000 patients enrolled in employer‐provided health plans in more than 200 companies across the Southwest, Northeast, Midwest and Southeastern regions of the United States. Both from region to region, and within the same regions, the price for the most widely prescribed imaging services at outpatient facilities, freestanding imaging centers, and physician offices varied significantly.
Study Shows Dramatic Disparities in Imaging Prices across the United States
Following the dramatic announcement of the results of the National Lung Screening Trial last month, one of the trial's participants, MD Anderson Cancer Center, has stated that it will begin routine lung screenings for at-risk smokers, even though the exams will not be covered by insurance companies.
MD Anderson was one of 33 sites involved in the national trial which randomized 53,000 current or former smokers - ages 55 to 74 - into two screening groups to compare and examine lung cancer mortality. One group received a low-dose helical CT scan and the other a standard chest x-ray. The findings, published in the New England Journal of Medicine, revealed a 20 percent reduction in lung cancer deaths for participants who received the low-dose helical CT scan compared with those undergoing a standard chest X-ray.
With Positive Trial Results, MD Anderson Begins CT Lung Screening
According to a new study published in Journal of the American College of Radiology, self-referring physicians are almost 2.5 times more likely to order imaging exams than clinicians with no ﬁnancial interest in imaging, translating into an increased imaging utilization rate of 59.7%. The study's authors suggested that the cost of this increased utilization could easily be in the billions of dollars.
Self-referred imaging is identified as physicians (or non-physicians) referring their patients either to their own imaging facilities or outside facilities in which they have financial interest. To better understand the effect of such financial incentives on clinicians' propensity to order imaging exams, the study's authors performed a meta-analysis of five previous studies on the issue, (from 1990 to 2007) analyzing over 76,905,162 episodes of care in total. Ultimately, the authors calculated the frequency of self-referred imaging to be 2.48 times that of imaging ordered by clinicians with no financial interest, (confidence interval of 95%; 1.90-3.24) a 59.7% increase in the utilization of imaging services amongst self-referring clinicians.
Self-Referrers 2.5 Times more Likely To Order Exams, JACR Study Finds