Navigation Links
Insurers Employ Multiple Solutions to Avoid Radiology Expense Spike

NASHVILLE, Tenn., Nov. 19 /PRNewswire/ -- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that while radiology costs have stabilized since first coming under scrutiny in 2005, insurers are seeing these costs quickly rise again. In several recent reports in Health Plan Analysis, HealthLeaders-InterStudy analysts find that to control costs, insurers continue to rely on traditional approaches such as pre-certification, but are also using multi-pronged strategies to educate providers about proper test usage.

"Industry observers estimate that radiology costs have risen more rapidly than other healthcare expenses. Contributing to this growth is the emergence of new technology, such as breast-specific gamma imaging and more widespread use of imaging technology in general," said Jane DuBose, Director of Health Plan Analysis for HealthLeaders-InterStudy. "Previously, spending was centered around hospitals, but now there are more independent testing facilities and physician offices have increased access to equipment, so health plans are actively engaging in cost containment strategies to help manage the increased cost of more widespread use."

UnitedHealthcare has initiated an imaging accreditation program for providers in 38 states. When a physician orders a test outside of guidelines from the American College of Radiology, a "peer to peer" dialogue occurs between UnitedHealthcare staff and the ordering physician. According to an official with UnitedHealthcare, this intervention has resulted in changed tests 3 percent of the time and cancellation of tests 9 percent of the time.

In Nevada, Anthem Blue Cross and Blue Shield is beginning to use data to give providers more information about best practices on imaging techniques, in hopes of lowering its imaging costs which account for 10 to 12 percent of its entire medical costs in the state.

Premera Blue Cross has launched a new initiative in Washington state that requires providers wanting to schedule an advanced imaging procedure to answer a series of questions. The intent is not approval or denial of the test, but merely to determine if the proper test is being requested in hopes of eliminating unnecessary or duplicated tests and, thus, decreasing costs.

"Plans throughout the country are struggling with how best to control imaging costs. Florida, for instance, as the home to 3.15 million seniors, is a hotbed for imaging, and leads the nation in radiology spending per Medicare patient. As use of imaging technology grows, health plans will likely explore more programs to ensure providers are up-to-speed on the latest guidelines," said DuBose.

About Health Plan Analysis

Health Plan Analysis identifies key health plan trends, allowing healthcare businesses to create comprehensive strategic plans and sales strategies at state and local levels. Updated quarterly, Health Plan Analysis provides a detailed look at plan design and financials, as well as information about mergers, legislation and other influencers driving healthcare in a particular region.

About HealthLeaders-InterStudy

HealthLeaders-InterStudy, a Decision Resources, Inc. company, is the authoritative source for managed care data, analysis and news. For more information, please visit

About Decision Resources, Inc.

Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources, Inc. at

All company, brand or product names contained in this document may be trademarks or registered trademarks of their respective holders.

    For more information, contact:

    Lisa Osgood                       Elizabeth Marshall
    HealthLeaders-InterStudy          Decision Resources, Inc.
    781-296-2606                      781-296-2563      

SOURCE HealthLeaders-InterStudy
Copyright©2008 PR Newswire.
All rights reserved

Related medicine news :

1. Blue Cross Blue Shield of Michigan Calls for Attorney General to Support Stronger Regulation of Commercial Insurers; Protections for Consumers; and Financially Stable Insurance Market
2. Anthem Blue Cross and Blue Shield in Connecticut Ranks in Top 10 of Insurers Nationwide on U.S. News & World Report/National Committee for Quality Assurance Americas Best Health Plans List
3. Anthem Blue Cross and Blue Shield in Maine Among Top Insurers on U.S. News & World Report/National Committee for Quality Assurance Americas Best Health Plans List
4. Anthem Blue Cross and Blue Shield in Maine Ranks in Top 6% of all insurers on U.S. News & World Report/National Committee for Quality Assurance Best Health Plans List
5. California Insurers are Behind the Curve with Consumer-Driven Health Plans
6. CA Legislatures Reform of Health Insurance Cancellations Resembles Insurance Industrys Own Plan; Insurers, Satisfied With Getting a Legal Edge Against Patients, Drop Opposition to the Bill
7. PacifiCare Rescission Settlement Gives Lip Service to Patient Losses But Stacks Legal Deck in Favor of Insurers
8. Nurses, Doctors, Patients to Protest Health Insurers on National Day of Action - June 19th
9. L.A. City Attorney Rocky Delgadillo, Patient Activists to Unveil New Television Ad Targeting Health Insurers
10. Bill Allowing Medical Privacy Intrusion Fails in Sacramento; Anti-Privacy Bill by Auto Insurers Faces Vote Wednesday
11. Nurses, Doctors, Patients to Protest Health Insurers at National Day of Action - June 19th
Post Your Comments:
(Date:12/1/2015)... ... 01, 2015 , ... Florida Hospital Tampa is the first health care provider in ... of Florida. , vBloc® Therapy is a vagal blocking therapy, delivered via the Maestro® System, ... mass index (BMI) of at least 40 to 45 kg, or a BMI of at ...
(Date:12/1/2015)... ... ... Dr. Paul Vitenas, one of the top cosmetic surgeons in Texas ... the Best Single Physician Practice in the nation. Dr. Vitenas and his practice were ... the industry publication. , Dr. Vitenas said he was very honored to receive ...
(Date:12/1/2015)... , ... December 01, 2015 , ... ... the 7th Annual 2015 Golden Bridge Business Awards under the New Products and ... zero capex web based sample management software that helps labs organize ...
(Date:12/1/2015)... ... December 01, 2015 , ... For ... mark the film for accurate interpretation by the radiologist. The marking utensils are ... from Sacramento, Calif., has found a way to alleviate this problem. , He ...
(Date:12/1/2015)... ... December 01, 2015 , ... McLean, VA., December ... a fixed price per sprint agile development contract to support the National Geospatial-Intelligence ... five years, provides software engineering, infrastructure, as well as operations and sustainment support ...
Breaking Medicine News(10 mins):
(Date:12/1/2015)... VERONA, Virginia , 1 de diciembre ... líder en tecnología para cuchillas de precisión, ... un programa de identidad de marca. El ... en el diseño y la ingeniería de ... toda la diferencia". ...
(Date:12/1/2015)... 2015 During the recent 2015 Transcatheter ... Francisco, CA , Medinol Ltd. continued to ... During a satellite symposium, "The BioNIR eDES: The ... Restenosis", a renowned physician panel discussed the key ... Coronary Stent System and the Medinol eDES Coronary ...
(Date:12/1/2015)... -- Relmada Therapeutics, Inc. (OTCQB: RLMD), a clinical-stage company developing ... that the company will present at the LD Micro Main ... Luxe Sunset Boulevard Hotel in Los Angeles, CA. ... will present on Thursday, December 3, at 9:00 am Pacific ... register at least 10 minutes prior to the start of ...
Breaking Medicine Technology: