Health insurers seek to curb costly use of diagnostic imaging.Several health insurers have launched programs targeted at curbing the use of diagnostic imaging procedures--by requiring providers to follow quality guidelines guidelines, n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. they've established for imaging--with help from the radiology radiology, branch of medicine specializing in the use of X rays, gamma rays, radioactive isotopes, and other forms of radiation in the diagnosis and treatment of disease. specialty. But a rift in the medical community may arise over such programs, said a medical society spokesman, and imposing strict guidelines could hinder hin·der 1 v. hin·dered, hin·der·ing, hin·ders v.tr. 1. To be or get in the way of. 2. To obstruct or delay the progress of. v.intr. patients' access to imaging services. Shawn Farley, a spokesman for the American College of Radiology The American College of Radiology (ACR), founded in 1923, is a non-profit professional medical organization composed of diagnostic radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians, and medical physicists. , said the issue concerns inappropriate use of imaging procedures by non-radiologist physicians. "We see this as a quality and safety issue, because our doctors are specifically trained," he said. Dr. Lew Sandy, executive vice president of clinical strategies and policy for UnitedHealthcare, a unit of UnitedHealth Group UnitedHealth Group Incorporated NYSE: UNH is a managed health care company. It is the parent of United Healthcare, one of the largest health insurers in the U.S. It was created in 1977, as UnitedHealthCare Corporation (it renamed itself in 1998), but traces its origin to a Inc., the nation's second-largest health insurer, said non-radiologist physicians are one of several factors. "The main issue ... is there is wide variation in the quality and cost effectiveness of imaging across the country," he said. "And neither physicians nor consumers have any guidance about who is doing a good job and who isn't." Health insurers, including UnitedHealthcare, have initiated various programs aimed at reducing the overutilization of diagnostic imaging services. According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. National Imaging Associates Inc., diagnostic imaging, at a projected $100 billion annually, is among the fastest-growing cost areas in U.S. health care. Driven in part by the advances in imaging technology and advertising directed at patients, radiology spending is expected to continue to grow at an annual rate of 20% or higher, NIA NIA National Institute on Aging (NIH) NIA National Indoor Arena (UK) NIA National Intelligence Agency (South Africa and Thailand) NIA National Institute of Accountants said. As much as 50% of imaging procedures ordered by non-radiologist physicians may be unnecessary, according to ACR See riser card. . Riding the Radio Wave About one third of advanced imaging tests may be either inappropriate or may not contribute to the physician's diagnosis or ultimate health outcomes. Appropriate use of advanced radiology varies depending upon the specialty of the ordering physician. Overall, appropriate selection of imaging was 72% over a recent study period--lowest for chiropractors, highest for OB-GYNs. Appropriate Imaging Selection Chiropractor 28% Cardiology 34% Primary Care Physician 56% Orthopedics 63% Neurology 69% Urology 78% OB-GYN 81% Note: Table made from bar graph. Source: National Imaging Associates Inc. |
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