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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

Social media’s ‘like’ effect increases clout of popular RSNA education exhibits

The more “likes” viewers give digital RSNA electronic education exhibits (EEEs), the more likely those EEEs are to win RSNA awards and/or be chosen to run in RSNA’s medical-education journal RadioGraphics.

Standardized-patient training is no cure for unnecessary image ordering

Primary care residents learning to better handle iffy patient requests by using standardized patients (SPs)—i.e., instructors portraying patients for training purposes—are more satisfied with the resulting interventions. However, they do no better at ordering fewer exams deemed to be of low value by Choosing Wisely guidelines.

Financial incentives do not increase breast cancer screening rates

Providing women with financial incentives to undergo breast cancer screening did not lead to significantly more of them receiving a mammogram, according to a randomized, controlled trial. The women all had private insurance through the Tufts health plan in Massachusetts.

Get off the sidelines: A radiologist’s guide to surviving payment reform

Value-based payments in radiology are here, and they are evolving fast. Nobody knows how they will morph, stretch, bend or otherwise play out in practice over the coming weeks, months and years. But there’s no more time to sit around waiting to find out before taking steps to adjust and prepare.

Radiologists losing share of overall physician workforce

The head count of radiology trainees in the U.S. blossomed 84.2 percent between 1997 and 2011, but the workforce expansion isn’t as heartening for the specialty as it initially sounds.

Study suggests possible LDCT screening benefit for 20- to 29-pack-year smokers

Should 20- to 29-pack-year smokers be screened for lung cancer via low-dose CT just like those with 30-plus pack-years? 

Valuing outcome metrics

Radiology should be shouting from the rooftops about the value they provide in order to avoid being commoditized. Despite this, the specialty lags behind in terms of measuring outcome-based quality metrics.

Translating ‘Radiology-speak’

My 85-year-old mother volunteers as an intake person at a free clinic, but her high school Spanish is long gone. This week, she found herself on duty without an interpreter and was amazed when a much younger volunteer pulled her smart phone from her pocket, spoke a question into it, and out came the question in Spanish.  The app performed the inverse function for the Spanish-speaking gentleman, and voilà, the registration ensued.

Fewer than 10% of people in the U.S. are uninsured

During the first quarter of 2015, seven million more people had health insurance compared with the same time period last year, according to a Centers for Disease Control and Prevention (CDC) report.

Stress test cost calculator now available online

A free-to-use online calculator to help providers assess the cost of nuclear stress tests is now available from University Nuclear & Diagnostics (UND).