Medicare should stop paying doctors who “self-refer” for imaging on equipment they own or lease — excluding payments for x-rays — because in most cases self-referral neither shortens the length of an illness nor provides cost-saving benefits, said researchers in the field.
An analysis of a random sampling of Medicare data for fee-for-service claims over a three-year period found that, with the exception of some x-rays, imaging self-referral not only failed to decrease the duration of an illness but also cost up to 10% more per total episode (from diagnosis to treatment) — raising the per imaging cost by as much as 40% — according to Danny R. Hughes, PhD, and colleagues at the American College of Radiology in Reston, Va.
The lone exception was for self-referred x-rays to diagnose chest pain, which shortened the duration of illness but did not make any significant difference in total costs, thus providing an overall advantage, Hughes and co-authors wrote in the December 2010 issue of Health Affairs.
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Source reference:
Hughes D, et al “Imaging self-referral associated with higher costs and limited impact on duration of illness” Health Aff 2010; 29(12): 2244-2251.
