GAO report recommends imaging cost controls

A new report from the Government Accountability Office is recommending that CMS look at ways to control Medicare's fast-growing imaging costs. In its research, the agency found that Medicare spending on imaging has more than doubled between 2000 and 2006, with use of more costly services like CT scans and MRI growing faster than traditional options like ultrasound and x-ray. It concluded that cost increases are connected to increases in imaging services offered inside physician offices, with such procedures rising from 58 percent to 64 percent of all CMS-paid services between 2000 and 2006. Its recommendations included requiring imaging providers to get prior authorization, a step that is becoming fairly common in private commercial plans.

You probably won't be surprised to hear that the imaging industry isn't thrilled with the GAO's conclusions. In fact, in a case of battling stats, the Medical Imaging & Technology Alliance cites a report (.pdf) by consulting firm Avalere Health suggesting that imaging volumes have actually leveled off among Medicare beneficiaries. (Bear in mind that the report was funded by MITA, though Avalere asserts that the conclusions are independent.) They argue that clinical guidelines for imaging use, developed by professional societies, do the best job of controlling utilization while making sure patients get needed studies.

To learn more about the dispute:
- read this Modern Healthcare article (reg. req.)

Related Articles:
MD self-referrals for imaging slipping through
Study: Specialists order more imaging within specialty

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.