MRIs linked to wasteful healthcare spending

Use of magnetic resonance imaging (MRI) climbed more than 350 percent between 1996 and 2010 a study published by the American College of Radiology (ACR) found, adding millions to healthcare costs without always delivering assumed value. Cases in point: knee and shoulder MRIs done without prior radiographs and stand-alone MRIs to find causes of back pain.

Knee and shoulder pain or tendonitis are common health complaints. ACR utilization guidelines say people with these symptoms should have radiographs before MRIs, according to a Health Imaging article. But not all practitioners follow the guidelines; some doctors order costly MRIs right away.    

Roughly 28 percent of knee MRIs and up to 37 percent of shoulder MRIs reviewed in the study occurred without prior radiograph exams of commercial and Medicare patients. The projected Medicare cost of these MRIs is between $20 and $35 million annually, the study determined.   

Overall, "MRIs performed without prior radiography represents a potential gap in care and should be considered as an area for establishment of performance measures," the authors concluded. The need for such measures may be more pressing since the MRI market is expected to grow by almost 5 percent annually over the next five years, as FierceMedicalImaging previously reported.

Moreover, new technology may be more helpful than MRI exams in diagnosing muscle-related back pain, Insurance Thought Leadership reported. Electrodiagnostic function assessment (EFA), for example, is a non-invasive, diagnostic device registered with the Food and Drug Administration. EFA can distinguish between spinal, neurogenic and musculoskeletal disorder conditions, which may help providers accurately diagnose causes of back pain, the article noted. This can contribute to improved patient outcomes.      

Patients with back pain routinely have abnormal MRI results regardless of their conditions, Insurance Thought Leadership noted. So relying on MRIs to find causes of back pain may lead to overtreatment--including unnecessary surgery--and send healthcare dollars down the drain.   

For more:
- here's the Insurance Thought Leadership article
- read the Health Imaging article
- see the Journal of the American College of Radiology study abstract