Imaging self-referral associated with higher costs and limited impact on duration of illness

Health Affairs

Volumn 29, Issue 12, 2010, Pages 2244-2251

  Hughes, Danny R ^a   Bhargavan, Mythreyi ^a   Sunshine, Jonathan H ^a  

^a AMERICAN COLLEGE OF RADIOLOGY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST; DIAGNOSTIC IMAGING; ECONOMICS; FACTUAL DATABASE; HEALTH CARE COST; HUMAN; MEDICARE; PHYSICIAN SELF-REFERRAL; PREVENTIVE HEALTH SERVICE; TREATMENT OUTCOME; UNITED STATES;

COSTS AND COST ANALYSIS; DATABASES, FACTUAL; DIAGNOSTIC IMAGING; DIAGNOSTIC SERVICES; HEALTH EXPENDITURES; HUMANS; MEDICARE; PHYSICIAN SELF-REFERRAL; TREATMENT OUTCOME; UNITED STATES;

EID: 79953802287     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2010.0413     Document Type: Article

References (21)

1. Hutchinson M, Chawluk JB, Gomez C, Greenberg J, Hussey FD, Preston WG, et al. Self-referral of imaging does not imply overutilization. J Neuroimaging. 2009;19(1):80-3.
2. American Urological Association. Talking points: physician self-referral [Internet]. Linthicum (MD): The Association; 2005 [cited 2010 Oct 4]. Available from: http://www .auanet.org/content/legislative-andregulatory/ imaging/selfreftalking points.pdf
3. Williams KA. Testimony at the hearing on managing the use of imaging services, before the Subcommittee on Health of the House Committee on Ways and Means [Internet]. Washington (DC): US Government Printing Office; 2005 Mar 17 [cited 2010 Nov 10]. Available from: http://frwebgate.access.gpo .gov/cgi-bin/getdoc.cgi?dbname= 109_house_hearings&docid= f:23927.pdf
4. Pontzer K. Statement at the hearing on managing the use of imaging services, before the Subcommittee on Health of the House Committee on Ways and Means [Internet]. Washington (DC): US Government Printing Office; 2005 Mar 17 [cited 2010 Nov 10]. Available from: http:// frwebgate.access.gpo.gov/cgi-bin/ getdoc.cgi?dbname=109_house_ hearings&docid=f:23927.pdf
5. Hillman BJ, Joseph CA, Mabry MR, Sunshine JH, Kennedy SD, Noether M. Frequency and costs of diagnostic imaging in office practice-a comparison of self-referring and radiologist- referring physicians. N Engl J Med. 1990;323(23):1604-8.
6. Hillman BJ, Olson GT, Griffith PE, Sunshine JH, Joseph CA, Kennedy SD, et al. Physicians' utilization and charges for outpatient diagnostic imaging in a Medicare population. JAMA. 1992;268(15):2050-4.
7. Mitchell JM. Utilization trends for advanced imaging procedures: evidence from individuals with private insurance coverage in California. Med Care. 2008;46(5):460-6.
8. Mitchell JM. Utilization changes following market entry by physicianowned specialty hospitals. Med Care Res Rev. 2007;64(4):395-415.
9. Iglehart JK. The new era of medical imaging-progress and pitfalls. N Engl J Med. 2006;354(26):2822-8.
10. Gazelle GS, Halpern EF, Ryan HS, Tramontano AC. Utilization of diagnostic medical imaging: comparison of radiologist referral versus samespecialty referral. Radiology. 2007; 245(2):517-22.
11. Mitchell JM. The prevalence of physician self-referral arrangements after Stark II: evidence from advanced diagnostic imaging. Health Aff (Millwood). 2007;26(3):w415-24. DOI: 10.1377/hlthaff.26.3.w415.
12. Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277-84.
13. Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med. 2009;361(9): 849-57.
14. Mettler FA Jr., Thomadsen BR, Bhargavan M, Gilley DB, Gray JE, Lipoti JA, et al. Medical radiation exposure in the US in 2006: preliminary results. Health Phys. 2008;95(5):502-7.
15. Medicare Payment Advisory Commission. Report to the Congress: improving incentives in the Medicare program [Internet]. Washington (DC): MedPAC; 2009 Jun [cited 2010 Oct 15]. Available from: http:// www.medpac.gov/documents/ Jun09_EntireReport.pdf
16. Levin DC, Rao VM, Parker L, Frangos AJ. The disproportionate effects of the Deficit Reduction Act of 2005 on radiologists' private office MRI and CT practices compared with those of other physicians. J Am Coll Radiol. 2009;6(9):620-5.
17. Centers for Medicare and Medicaid Services. Berenson-Eggers Type of Service (BETOS) codes [Internet]. Baltimore (MD): CMS; 2009 [cited 2009 Dec 2]. Available from: http://www.cms.gov/HCPCSReleaseCodeSets/20_BETOS.asp
18. Bureau of Labor Statistics. Consumer Price Index: all urban consumers [Internet]. Washington (DC): BLS; 2009 [cited 2009 Jun 16]. Available from: http:// www.bls.gov/cpi/
19. To access the Appendix, click the Appendix link in the box to the right of the article online.
20. Winter A. Services provided under the in-office ancillary exception to the physician self-referral law [Internet]. Washington (DC): Medicare Payment Advisory Commission; 2010 Jan 15 [cited 2010 Feb 18]. Available from: http://www .medpac.gov/transcripts/In-office% 20services_Jan%202010_public.pdf
21. Medicare Payment Advisory Commission. Report to the Congress: aligning incentives in Medicare [Internet]. Washington (DC): MedPAC; 2010 Jun [cited 2010 Oct 15]. Available from: http://www.medpac .gov/documents/Jun10_Entire Report.pdf