Similar to the rise of electronic health records and digital imaging equipment, radiologists have been preparing for the evolution of radiology for years. Many health care providers are examining their existing protocols for scans to determine factors leading to the overuse of imaging services.
Geography has little to do with overuse
According to a new study published in the Annals of Internal Medicine, geographic variations in imaging use do not directly correlate to excessive exams. Health care policymakers have previously argued that disparate regional usage of radiology equipment was contributing to an overall increase in clinical expenses, and that limiting these variations should be a key effort for providers.
To assess these claims, J. Michael McWilliams, Ph.D., and a team of researchers at Harvard Medical School investigated the variations by focusing on cancer-related imaging data from the Veterans Affairs health care system and comparing it to traditional fee-for-service Medicare cases, AuntMinnie.com reported.
"While geographic comparisons can be useful for understanding trends in provider behavior, our study demonstrates that geographic variation is not necessarily a reliable indicator of the extent of overuse in a healthcare system," said McWilliams, quoted by the source.
The team reviewed Medicare claims from 2003 to 2005, in addition to data from the VA for the same time period for men over the age of 65 with lung, colorectal or prostate cancer diagnoses. The study covered 40 hospital regions across 23 states, which made up 22 percent of the Medicare population in 2005. McWilliams and his researchers wanted to determine if the rate of cancer-related scans was lower for VA patients and associated with less geographic variation.
There were more than 40,000 patients included in the study. The Harvard team found that adjusted annual use of diagnostic imaging in the VA group was lower than Medicare, with CT, PET and nuclear studies making up 90 percent of the difference. The findings represent an opportunity to trim waste from the health care system, and the fact that geographic variation is not a viable parameter for quantifying the overuse of scans.
Planning for the future of radiology
FierceMedicalImaging explained that evolving payment models, decreasing reimbursements and rising calls for transparency represent the dramatic changes on the horizon for radiology. As a result, practices are implementing new models to plan for the future.
For example, Spectrum Medical Group has continued to merge various practices under one roof to expand its services, such as radiology, anesthesiology and pathology facilities. Since launching in the early 1990s, Spectrum now covers more than 50 percent of all radiology services in Vermont. By merging systems, the facility was able to follow the industry's steady trend of growth.
On the other hand, smaller practices, such as Advanced Radiology Consultants in Shelton, Connecticut, have maintained a modest size while continuing to oversee specific geographical areas of the radiology market. According to Alan Kaye, M.D., the practice's president, staying small has allowed for more flexibility to coincide with the swift changes in the industry.
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Ronny Bachrach
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