How Quality Standards for Imaging Save Taxpayer Dollars, While Protecting Patients
High-end imaging (MRI, PET, and CT) is experiencing explosive growth because physicians, with little or no training in how to accurately read and safely perform such scans, are profiting by referring their patients for testing in their own offices. Quality standards will help to prevent inappropriate, financially driven utilization of high-end imaging and help to ensure that Medicare beneficiaries receive quality, safe medical imaging from the most qualified providers.
Billions in Savings, Improvements in Imaging Quality
The American College of Radiology (ACR) estimates that quality standards can save approximately $5 billion in Medicare costs over 10 years. Given the likelihood that Medicare spending on medical imaging may approach $100 billion over the next decade, deterring just 5% of projected spending would represent a substantial savings to Medicare and improve patient care.
The Medicare Payment Advisory Commission (MedPAC), an expert advisory group formed to advise Congress, has concluded that standards for high-end imaging can simultaneously improve imaging quality while reducing Medicare costs.
Quality Standards Already Working
Experience from the private sector shows us that quality standards work. Federal standards already protect women undergoing mammography tests, and private payers such as UnitedHealth Group, Anthem, Tufts Health Plan, and Blue Cross Blue Shield, are effectively using quality standards to control costs and prevent risks from advanced scans. Medicare patients deserve the same protection and assurances when undergoing advanced medical imaging.
ACR Makes Recommendations
Quality standards proposed by the ACR would help to ensure patients that their medical imaging tests are being conducted and supervised by uniquely qualified physicians. The ACR proposes several standards for Medicare reimbursement of high-end imaging, including annual safety evaluations of equipment, mandatory training for imaging technologists, and a requirement that only physicians with the training needed to make sound medical judgments about MRI, CT, and PET images are permitted to supervise and interpret such tests.
Congressional Testimony Shows Support for Standards
At the March 17, 2005, hearing before the House Ways and Means Committee, Mark D. Miller, PhD, executive director of MedPAC, made his case for standards by stating, “The Congress should grant the Secretary authority to develop standards . . . CMS should strongly consider setting standards for at least the following areas: the imaging equipment, qualifications of technicians, qualifications and responsibilities of the supervising physician, technical quality of the images produced, procedures for ensuring patient safety, and the professional training, experience, and education of physicians who interpret studies.”
At the same hearing, Cherrill Farnsworth, chairperson of the National Coalition for Diagnostic Imaging Services, also supported quality standards. She stated that, “Quality standards for equipment and facilities would reduce the need for duplicate scans or expensive therapy from incomplete images or misdiagnosis.” She also said that in order to “protect patient safety and reduce medical errors, physicians billing Medicare for imaging services should meet certain training and education standards.”
It’s clear that by enacting quality standards, Congress can save taxpayer dollars while improving patient care and safety.