Outpatient no-shows for scheduled imaging exams can cost a radiology department at a standard U.S. academic medical center as much as $1 million in lost revenue per year, according to a study published June 12 in Academic Radiology.
Researchers led by Rebecca Mieloszyk, PhD, a radiologist solutions scientist at Philips Healthcare and radiology professor at the University of Washington, found that mammography had the highest no-show rates compared to MRI brain scans, CT chest scans, ultrasound abdomen scans, CT head scans and ultrasound breast scans.
"Each no-show appointment represents a missed opportunity to deliver appropriate care as well as to receive payment for that patient visit," Mieloszyk and colleagues wrote. "In modalities that have fixed costs like radiotracers or specialty technologists, there is an added fixed component to the already substantial opportunity cost."
To explore lost revenue from radiology no-show appointments, the researchers assumed that a standard U.S. academic medical center does not require a patient to pay for missing an imaging appointment and defined lost or "uncaptured" revenue as the post-charge that could have been received by the institution had the patient come to their scheduled exam, according to the researchers.
Additionally, Mieloszyk and colleagues assumed that a standard U.S. academic medical center performs imaging with computed radiography, CT, mammography, MRI, nuclear medicine and ultrasound while performing an estimated 200,000 exams per year.
"We report corresponding Medicare charges according to those provided for 2018," the researchers wrote. "Additionally, we assume exam charge ranges in line with typical charge masters at large institutions."
The researchers found that per exam, uncaptured revenue ranges up to $15,000 per year for breast ultrasound and up to $350,000 per year for mammography screening. Per year, brain MRI, abdomen ultrasound and mammography screening each exceeded $100,000 in uncaptured revenue, according to the researchers.
"Results of this exploration demonstrate that the greatest annual uncaptured revenue need not correspond to the most performed or the most expensive exams," Mieloszyk and colleagues wrote. "Mammography screening, one of the lowest-cost exams, can in fact impose a large burden of uncaptured revenue. This trend may be due to screening exams being viewed by the patient as easily deferred."
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.