Unnecessary imaging costs U.S. up to $12 billion annually

A survey of hospital executives has determined that the U.S. healthcare system spends at least $7.47 billion, and as much as $11.95 billion on unnecessary imaging every year.

The survey and accompanying report--performed by the consulting company peer60--included data collected from executives, including chief medical officers, chief medical information officers and department heads from 196 hospitals across the United States.

According to the survey results, the most widespread cause of unnecessary imaging was defensive medicine, with more than 90 percent of respondents calling it a prime contributing factor. Other important contributing factors were patient demand (mentioned by 65 percent of respondents) and physician unfamiliarity with appropriate diagnostic tests (60 percent).

When asked what percentage of imaging volume they considered to be unnecessary in their hospitals, more than half of the respondents said it was greater than 10 percent, while one-third said it was between 6 and 10 percent.

According to the report, the above reasons for unnecessary imaging are "exacerbated" by payment models that encourage volume over quality; to that end, they said, the move toward quality-based reimbursement should help reduce inappropriate imaging.

Automated prior authorization combined with evidence-based clinical guidelines, as well as "physician engagement" can significantly reduce overutilization of advanced imaging services, according to a study published last year in the Journal of Managed Care Medicine.

More than half of peer60 survey's respondents said that reducing inappropriate imaging was a top priority. Of those who said it wasn't a top priority, 16 percent said it was because they had put solutions in place involving a mix of homegrown technology and process improvements.

"These findings demonstrate a serious issue in health care spending that is raising all of our costs," peer60 CEO Jeremy Bikman said in an announcement. "But there is hope in the form of quality-first payment reform coupled with software tools being developed that will greatly assist referring physicians and radiologists alike."

To learn more:
- see the report
- see the announcement