Analysis: High costs, price variability mean imaging should be a healthcare savings target

Medical imaging procedures figure prominently in a list of the high-cost, high-frequency and highly variable medical services that present the greatest opportunities to achieve healthcare savings, according to an analysis from Change Healthcare's quarterly Healthcare Transparency Index.

The index tracks cost variability of common healthcare services across various prescription, medical, dental and vision services. Among these services, Change Healthcare identified eight "target" categories with the greatest opportunities for cost savings. Those eight included five related to medical imaging: CT scans; MRI; colonoscopies and upper GI endoscopies; mammograms; and ultrasound.

According to the analysis, CT scans have the greatest variability in price at 794 percent, with costs ranging from $300 to more than $2,600. Ultrasound ranks next at 472 percent ($100 to $572), followed by MRI at 458 percent ($485 to $2,708), mammograms at 242 percent ($118 to $402), and colonoscopies and upper GI endoscopies ($1,290 to $4,035).

Price variations can be even greater depending on the type of modality and area of the body being imaged. For example, CT scans of the pelvis/abdomen varied in price by 988 percent, and abdominal ultrasounds by 611 percent.

"Our data show costs for common procedures can vary significantly, even in the same zip code," Doug Ghertner, president and CEO of the Brentwood, Tenn.-based company that provides pricing information to health payers and employers. "Care setting may contribute to costs differences, but often there's little explanation for why common treatments may cost two, three or four times more at one provider versus another."

Ron Vianu, CEO of a company that provides data on imaging to employers and worker's compensation insurance carriers, told in Bloomberg Businessweek, however, that price is not a good determinant of quality care when it comes to medicine, "and particularly radiology."

Vianu added that since insurers negotiate different rates with different providers, two equivalent imaging centers could have vastly different costs. Hospital prices could be even harder to judge, he said, because they bargain on a wider variety of services.

To learn more:
- read about the announcement from Change Healthcare
- see the article in Bloomberg Businessweek

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