Imaging programs reduce costs

December 1, 2012

Unnecessary diagnostic tests are harmful to patients and costly for health plans.

LOS ANGELES-Unnecessary diagnostic tests such as echocardiograms and computed tomography scans are harmful to patients and costly for health plans. Such tests can be avoided with the help of imaging management programs, according to an analysis from AIM Specialty Health and HealthCore, both WellPoint subsidiaries.

The analysis recorded a 12% overall reduction in the likelihood of follow-up tests, including myocardial perfusion imaging and cardiac CT scans.

The study hypothesized that members in plans with utilization management programs were less likely to have repeated imaging because the programs evaluate the need for the test against appropriateness criteria. Claims data from 96,906 commercially insured Anthem members in Indiana, Kentucky, Missouri, Ohio and Georgia was reviewed.

Allowing relevant factors such as age, gender, comorbidity, medication use, and cardiovascular event history, the repeat testing rate was lower for the managed group.

According to AIM, unnecessary testing has no positive impact on patient outcomes, and might have procedural risks and unnecessary radiation exposure. Studies published in 2010 and 2011 indicate that approximately 15% of cardiac imaging exams are inappropriate based on criteria established by the American College of Cardiology. -Miranda Hester