Tuesday, October 6, 2009

The Cost of Care, Part 3

The third part of the Dallas Morning News’ five part series called “The Cost of Care” covered the medical imaging industry, which is quickly growing in size and scope. However, some worry that unnecessary scans are driving up expenses. You can access the series here.

The article examines why business is so good for those in medical imaging, which generates $100 billion a year nationally. As The News points out, “More imaging machines has meant significant increases in use, and rising costs for American consumers and taxpayers.”

I have said before that CT scans and MRIs are over-utilized for many reasons, including the fact that patients may demand them because of marketing done by vendors, clinicians may find it easier and faster to do a study rather than spending the time to do an extensive and complete history and physical and because these studies are—at least currently—significantly reimbursed.

The News also quotes a McKinsey Global Institute study, which found that “extra U.S. capacity results in about $26.4 billion in additional costs annually for CT and MRI scans.” The author points to other potential reasons for physician overuse of these technologies, including self-protection from potential malpractice claims, or financial reasons--referring patients for scans to be done on machines they own.

Technologies that have been developed for diagnosis can be extremely beneficial, but can also quickly decrease in overall value because their ease of deliverance and their high financial reimbursement may cause them to become over-utilized. As this technological equipment becomes more affordable, their availability exceeds need and only accentuates the potential for their overuse.

Reform in the U.S. may address some of these issues. (The Texas Legislature has thus far been unsuccessful.) Until then, we will continue to carefully monitor the development and introduction of new technologies, ensure that we’re acquiring and locating appropriate numbers of these technologies in our various regions and business units, utilizing appropriate guidelines to minimize overuse.

1 comment:

NOYFB said...

Dr. Royer,

Thanks for taking the time to post on your blog. It is valuable insight for me to hear from the man at the top of the pyramid.

From a technical standpoint, it is incredibly well written and appropriately linked - i.e. easy to use.

i work as a physician/radiologist at a Christus facility and have put considerable time and effort into trying to solve the utilization conundrum.

Re: the cost of care - if i told you that a cluster of Christus facilities were knowingly overpaying "nighthwak" teleradiogy services by 40%, would that warrant your attention ? it is happening and right now and is only the iceberg's tip. surely you have seen such inattention before but it is novel to me and worthy of involvement.

I'd like to be helpful beyond scrolling a mouse and speaking into a dictaphone. You may contact me via infinite.stoke@gmail.com

Keep writing!