The Value of the Right Scan at the Right Time: Promoting Appropriate Use of Imaging Services

The Value of the Right Scan at the Right Time: Promoting Appropriate Use of Imaging Services

Medical imaging tests are central to modern patient-care. They ensure that life-threatening health
conditions are caught early and Medicare beneficiaries can be treated sooner. This prevents the
need for more invasive, and often more costly, diagnostic procedures as well as the monetary and
emotional costs due to late-stage diagnosis.

To preserve access to these life-saving services, Congress should prevent further reductions to
Medicare payments for imaging services and should require a transparent, evidence-based
process for the appropriate use of medical imaging. This will help to ensure a baseline of
imaging quality and safety that patients deserve.

Patient-Centered Solutions Are Available

The right scan at the right time is a better approach.

Rather than additional deep and arbitrary cuts to medical imaging which threaten patient access
to care, Congress should promote the development and implementation of physician-developed
appropriateness criteria to ensure the proper use of imaging and to reduce cost.

The right scan at the right time works for providers

As imaging continues to be increasingly integral to best clinical practice, physician-developed
appropriateness guidelines, with IT-based clinical decision support tools, may provide the
answer. Leading private health systems, such as Massachusetts General Hospital (MGH), are
currently using or piloting appropriateness criteria. The use of appropriateness guidelines at
MGH reduced the outpatient CT growth from 12% annually down to 1%. This decrease
occurred even as the growth of outpatient visits to the same facility increased steadily at a
compound annual growth rate of nearly 5%.

Further, as the criteria are developed through physician consensus, there is agreement on the
state of the science. This gives practitioners and providers the technical support and up-to-date
science to support their medical decisions.

The right scan at the right time saves lives.

A study conducted by Professor Frank Lichtenburg found that advanced imaging techniques
extended life expectancy in the US by 0.62 – 0.71 years over the time period 1991-2004.

The right scan at the right time saves dollars.

According to researchers at Harvard Medical School, every $385 spent on imaging decreases a
patient’s hospital stay by one day, saving approximately $3,000 per patient. Coronary Computed
Tomographic Angiography (CCTA) detects coronary artery disease with over 90% accuracy,
saving patients from exploratory surgery or catheterization. The University of Michigan’s
Stroke Program showed CCTA saved $2,353 per patient compared to standard catheterization in
Journal of Neuroimaging (October 2008).