Physician ownership of certain diagnostic medical equipment may be high enough to cause concerns about how they affect volumes of self-referrals, suggests a new report by the Center for Studying Health System Change (HSC).
Federal law banned many physician self-referrals in the early 1990s, but exceptions remained, particularly if care was rendered in the physician's office. The HSC noted that the huge growth of outpatient care may have helped physicians exploit this exception.
The study, which uses data the HSC compiled in 2008 through its own physician surveys, noted that nearly one in seven physicians in community-based, physician-owned practices own or lease three or more types of equipment to perform laboratory, x-rays or advanced imaging services. In some instances, leasing or ownership is much higher: among pediatricians, more than 46 percent have control over some form of their laboratory equipment. Among primary care physicians, nearly a quarter own equipment for some non-invasive procedures.
The rates of equipment leasing and ownership skyrockets if the practice includes three or more physicians.
The study's authors noted that starting in 2011, physicians are required to make financial interest disclosures to any patients seeking imaging services and must provide alternative supplies. However, they concluded "that given the growing evidence that physician self-referral contributes to unnecessary and costly care, policy makers might reconsider the broadness of the in-office ancillary service exemption to the Stark law."
- read the study findings
- read the HSC press relase