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Healthcare Economics & Policy

 

In its fourth annual update on medical overuse, JAMA Internal Medicine names 10 procedures and practices that are ripe for the curtailing. In the category of “overtesting,” the klieg lights fall on four exams—and all are based in imaging.

Anthem’s recent decision to no longer pay for outpatient CT and MR exams performed in hospitals didn’t come from nowhere—and, going forward, the move is not likely to be an outlier among private payers’ business stratagems.

In Harris County, Texas, three outpatient family-medicine affiliates of Baylor College of Medicine have slashed their unnecessary orders of lumbar-spine MRIs—and improved the appropriateness ratings of those they did order—by attending educational sessions and using the American College of Radiology’s R-SCAN program.

Offering first-year medical students an elective introduction to interventional radiology (IR), researchers at the University of Pennsylvania and its Perelman School of Medicine have found considerable receptivity to the learning opportunity and heightened interest in the specialty.

It’s no secret that radiology ranks among the medical specialties with the highest mean markups on list prices. However, a new review of Medicare data on prices listed and payments made shows that, far from being arbitrarily set—as is often assumed if not alleged—many of radiology’s highest prices reflect real-world, case-by-case factors involving heightened risk, greater clinical complexity and increased need for subspecialized expertise.

 

Recent Headlines

Rejecting the recommendations, urologists and older docs persist in ordering prostate screening

The USPSTF’s reiterated recommendations against prostate-cancer screening for men with limited life expectancy have resonated with geriatricians and younger primary care physicians but failed to sway substantial numbers of urologists and older practitioners, as shown by a large study of veterans published April 4 in JAMA Internal Medicine.

Diagnostic imaging market set to eclipse $33 billion by 2020

A new report predicts substantial growth for the global diagnostic imaging market over the next five years, with the market expected to top $33.4 billion by the year 2020.

Market researcher sees global imaging sales approaching $37B by 2020

The U.K.-based market research firm Technavio has pegged the global medical imaging market to close in on $37 billion in revenue by 2020, according to a Feb. 26 press release from the firm promoting a report available for purchase.  

Comparative effectiveness research winning hearts and minds but not moving mountains

There is no shortage of buy-in on the concept of comparative effectiveness research as promoted by HHS’s Agency for Healthcare Research & Quality in the Affordable Care Act era, but the assent isn’t translating into impact, according to a study in the February edition of the Journal of Comparative Effectiveness Research.

Opinion: Physician autonomy key to outcomes improvement

The only true measure of the value a physician brings to the U.S. healthcare system is the degree to which he or she helps bring about good clinical outcomes. 

McGinty: Rads can have their Triple Aim moment and get paid for it too

Improve population health. Optimize the patient experience. And do both while cutting costs. That, of course, is the “Triple Aim,” the Institute for Healthcare Improvement’s boiled-down recipe for putting the Affordable Care Act into action at the provider level. And where does radiology fit into the formula? 

As an imaging cost-cutter, high-deductible insurance may be a ‘blunt instrument’

As a way to cut overall imaging utilization and spending, increased patient cost-sharing via high-deductible health insurance seems to work. But the approach may not do much to help patients tell medically recommended exams from frequently wasteful ones. 

Another reason to think twice before getting that pricey lumbar MRI exam

A lot of people spend a lot of money searching for relief from pain in the lower back. It turns out the surest solution may also be the cheapest.

Pysch prof to researchers: Please publish studies anonymously

Flattery. Nepotism. Popularity bias. The real motives driving the Hollywood Foreign Press Association’s choices of Golden Globe winners? No—a few of the foibles compromising the integrity of name-based academic research, including peer-reviewed work published in medical journals. 

Three studies, one call for imaging ‘more wisely’

The time has come for patient-facing physicians to collaborate more closely with radiologists in deciding whether or not to image. And, going forward, the decision must incorporate patients’ values about “the pressing need to perform imaging tests more wisely.”

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