RBMs could save $24B by 2020
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The implementation of a radiology benefits management (RBM) program could result in significant savings to the Medicare Fee-for-Service (FFS) program, according to a study commissioned by National Imaging Associates (NIA), a subsidiary of Magellan Health Services, and performed by consultants with Milliman, an independent actuarial and consulting firm.

The report, "Potential Savings to Fee-for-Service Medicare from Radiology Benefits Management Programs," projects that RBM programs for advanced imaging services could save between $13 billion and $24 billion by the end of 2020 if implemented in Medicare FFS beginning in 2012.

These findings were extrapolated from actual Medicare Advantage data from 10 health plans and represent a real world estimate that reflects empirical data and the Medicare system of care. The study projected that there will be $121 billion in advanced imaging services covered by fee-for-service Medicare from 2011 to 2020 if current practices remain. Two alternative scenarios that utilize RBMs to manage advanced imaging costs show the potential to save from $13 billion to $24 billion in federal budget expenditures and patient cost sharing.

Key findings of the report include:
  • Without program changes, the total allowed charges associated with advanced imaging services will be approximately $121 billion from 2011 through 2020;
  •  With RBM implemented in Medicare FFS and an assumed impact in only the first year, the savings range from $13 to $17 billion over 10 years; and
  • With RBM implemented in Medicare FFS and an assumed impact that extends to the first and subsequent years through a 50 percent reduction in utilization trend, the savings could range from $20 to $24 billion.

A full copy of the report can be found here.
Evan Godt
Evan Godt, Writer

Evan joined TriMed in 2011, writing primarily for Health Imaging. Prior to diving into medical journalism, Evan worked for the Nine Network of Public Media in St. Louis. He also has worked in public relations and education. Evan studied journalism at the University of Missouri, with an emphasis on broadcast media.

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