Fast-growing spending on imaging tests in Massachusetts gives a closeup view to the many-sided question of whether improved technology is really worth the extra cost.
The facts, as laid out by the Boston Globe this morning: Spending on MRIs, mammograms, and other imaging tests for privately insured Massachusetts residents jumped 20%, or $214 million, between 2006 and 2008, according to consultants hired by the state. Doctors ordering more tests was one reason for the added spending.
Digital mammography was another prime driver as some insurers pay more for these breast-screening tests and hospitals have invested upward of $400,000 for such new machines, compared with $100,000 for earlier units. The digital technology is faster and can be used with electronic health records.
But there hasn’t been any evidence that digital mammograms hold a significant edge in detecting cancer in most women compared with older tests, the Globe says. It also turns out that more imaging tests these days are being done in hospitals, which charge more for the services than independent clinics.
A scan done in a hospital is of no better quality and is not being read by a more qualified radiologist than one done in a freestanding clinic, the paper quotes an official at insurer Harvard Pilgrim Health Care as saying. On the other side, the Globe writes that hospital officials believe
the states consultants overstated the role higher provider fees are playing in pushing up costs. And, they said, the increase in the number of scans has slowed significantly since 2008, as more insurers began requiring preauthorization for certain scans.
A company that manages radiology benefits for insurers also tells the Globe that makers of imaging equipment lobbied Congress for higher payments from Medicare to encourage service providers to buy the new technology and helping generate premium payments from private insurers for tests done with digital gear.
Photo: Associated Press