Health plans attempt to rein in radiology
While prescription cost increases have moderated, radiology costs grow
almost 20% a year, according to new research from HealthLeaders-InterStudy
7 February 2005
NASHVILLE, USA. HealthLeaders-InterStudy, a leading provider of managed
care industry intelligence, finds that health plans are taking steps to rein
in the cost of radiology. According to findings in the recent Health Plan
Data and Analysis reports, while prescription drug costs and hospital-payer
contracts have received the most attention in the past five years, radiology
costs have been growing at a remarkable rate.
"Radiology accounts for only 10 cents of each medical dollar spent by
health plans," according to HealthLeaders Research Market Analyst Jane
DuBose. "But the segment is growing by 18% to 20% a year. In contrast,
interventions in prescription drug management by health plans have slowed
the growth rate of pharmaceutical costs to below 10% in some cases."
To battle the issues of duplication and overuse of expensive imaging,
health plans are using precertification and radiology copays and dictating
guidelines for physicians. Health plans may also require that imaging
studies be performed according to guidelines from the American College of
Radiology or other organizations.
"Central to radiology management is data gathering, which shows when
providers' ordering and denial rates are outside the norm," continued Ms.
DuBose. "We expect more sophisticated use of data as vendors and health
plans consider ways to reward quality and try to uncover why costs vary so
much by region."
Demographic trends and continued technological advances will also mean
higher utilization in the future; cardiac imaging expected to be one of the
next big areas of medicine.
CONTACT: Elizabeth Marshall of Decision Resources, +1-781-296-2563,