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Quality First

Private sector initiatives inform government effort to control escalating use of high-tech diagnostic imaging.

By: Lisette Hilton
Date: November/December 2008
Source: America’s Health Insurance Plans


A report released in June by the U.S. Government Accountability Office analyzes a dramatic upswing in the use of high-tech diagnostic imaging in Medicare Part B and recommends strategies to help Congress safely curb spending on imaging services, many based on radiology benefit management programs already in place at private health insurance companies.

The GAO report, “Medicare Part B Imaging Services: Rapid Spending Growth and Shift to Physician Offices Indicate Need for CMS to Consider Additional Management Practices,” found that, from 2000 to 2006, spending for imaging services paid under the physician fee schedule more than doubled—increasing to about $14 billion. Spending on high-tech imaging, including CT, MRI, PET scans, and nuclear cardiology studies, rose almost twice as much a year, on average, as standard imaging, such as ultrasound and X-rays.

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Quality First

Quality First