Featured Research

from universities, journals, and other organizations

Self-referring Physicians Behind Increase In Diagnostic Imaging, Researcher Argues

Date:
April 26, 2008
Source:
Baylor College of Medicine
Summary:
Physicians who refer patients to their own facilities or machines for scans account for much of the increase in diagnostic imaging ordered for privately insured patients according to a new article.

Physicians who refer patients to their own facilities or machines for scans account for much of the increase in diagnostic imaging ordered for privately insured patients said a Baylor College of Medicine expert in a commentary that appears in the journal Medical Care.

Related Articles


Based on a study also appearing in the same issue, Dr. Vivian Ho, professor of medicine at BCM and associate professor of economics at Rice University, wrote: "Increases in utilization rates were substantially higher for scans performed by self-referring physicians than for images that originated from a referral to a radiologist or hospital."

The increase was seen mainly in those patients covered through private insurance that provided the physician with a fee for service reimbursement.

In the study upon which Ho was commenting, Dr. Jean M. Mitchell, professor of public policy at Georgetown University in Washington, D.C., reviewed data recorded between 2000 and 2004 from a large private insurer in California. This information was then compared to a report by the Medicare Payment Advisory Commission. Both reports showed an increased use of imaging tests for those with private insurance.

"Physicians seem to choose the self referral option, meaning they do the imaging in their own office, because they are reimbursed by private insurance companies," Ho said. "The other option would be to refer the patient to a radiologist or an outside diagnostic center."

Federal law does not allow reimbursements for many self-referral arrangements, unless the imaging is done in-office. This exception is allowed because physicians who perform the procedure in-office are providing a convenience to patients.

However, in most cases reviewed in the Mitchell study, the doctors did not have the imaging machinery in their offices. Physicians are able to skirt the restriction by leasing an imaging center's facilities and employees for a fixed period per week.

"This creates revenue for both parties involved," Ho said. "But it also raises a lot of questions such as would it have mattered if another test had been done, one that didn't receive a reimbursement?"

Ho said it is important to remember that imaging technology has advanced in the past years and now takes the place of much more invasive diagnostic measures such as surgery. However, she said, no one has studied whether one test would have had benefit over another during the course of a patient's illness.

Ho cites other studies of a trend toward manufacturing and marketing cheaper, lower quality imaging instruments. However, the level of reimbursement, regardless of the cost or quality of the equipment used, remains the same.

She writes, "The current reimbursement system lacks incentives to provide high quality imaging in a cost effective manner."

Finding an answer to this problem will take creativity.

"Doing away with the reimbursements will only penalize those physicians who are actually providing imaging in-office as a convenience to their patients," Ho said.

In her commentary she writes, "Unfortunately, the legal system, the method of reimbursing physicians, and our lack of tools to monitor appropriateness of testing have led to significant increases in diagnostic imaging, which likely provide little health benefit to patients."

The solution should involve policy makers, insurers, physicians and health service researchers.

"Only then can we insure that advanced imaging technologies yield a benefit, rather than become a burden to the health care system," said Ho.


Story Source:

The above story is based on materials provided by Baylor College of Medicine. Note: Materials may be edited for content and length.


Cite This Page:

Baylor College of Medicine. "Self-referring Physicians Behind Increase In Diagnostic Imaging, Researcher Argues." ScienceDaily. ScienceDaily, 26 April 2008. <www.sciencedaily.com/releases/2008/04/080424171831.htm>.
Baylor College of Medicine. (2008, April 26). Self-referring Physicians Behind Increase In Diagnostic Imaging, Researcher Argues. ScienceDaily. Retrieved October 24, 2014 from www.sciencedaily.com/releases/2008/04/080424171831.htm
Baylor College of Medicine. "Self-referring Physicians Behind Increase In Diagnostic Imaging, Researcher Argues." ScienceDaily. www.sciencedaily.com/releases/2008/04/080424171831.htm (accessed October 24, 2014).

Share This



More Health & Medicine News

Friday, October 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Breakfast Debate: To Eat Or Not To Eat?

Breakfast Debate: To Eat Or Not To Eat?

Newsy (Oct. 23, 2014) Conflicting studies published in the same week re-ignited the debate over whether we should be eating breakfast. Video provided by Newsy
Powered by NewsLook.com
Ebola Fears Keep Guinea Hospitals Empty

Ebola Fears Keep Guinea Hospitals Empty

AP (Oct. 23, 2014) Fears of Ebola are keeping doctors and patients alike away from hospitals in the West African nation of Guinea. (Oct. 23) Video provided by AP
Powered by NewsLook.com
Despite Rising Death Toll, Many Survive Ebola

Despite Rising Death Toll, Many Survive Ebola

AP (Oct. 23, 2014) The family of a Dallas nurse infected with Ebola in the US says doctors can no longer detect the virus in her. Despite the mounting death toll in West Africa, there are survivors there too. (Oct. 23) Video provided by AP
Powered by NewsLook.com
Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins