Self-referral for imaging leads to overuse, higher costs, studies show

Diagnostic Imaging | December 10 – Self-referral of imaging services by non-radiologists doesn’t necessarily benefit patients, and can lead to overuse and increased spending. Those are the conclusions of a series of studies published this week in the December issue of Health Affairs.

The findings bolster the arguments against other specialists purchasing and using imaging equipment. Proponents say self-referral provides convenience for patients and often improved quality of care.

Not so, researchers found.

“The publication of these articles in a concentrated fashion by the country’s most prestigious health policy journal should put an end to any doubt on the part of patients and payers and fair-minded physicians that the in-office ancillary service exception needs to be eliminated,” said Alan Kaye, MD, chair of the radiology department at Bridgeport Hospital, Yale New Haven Health System, in Bridgeport, Conn. “I really do think this is the tipping point.”

The self referral issue was also raised in an article this week in the Wall Street Journal, which examines urologists’ use of IMRT (intensity-modulated radiation therapy) for the treatment of prostate cancer. Use of the radiation therapy has spiked in recent years, and the newspaper’s analysis shows IMRT use (which brings in big money) is higher in states where most of the urology groups that own the equipment are located.

“It’s becoming pervasive,” Kaye said of imaging self referral, adding that studies have shown “virtually all” diagnostic imaging growth has come from self-referred situations.


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