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New Study Questions Ability of Radiology Benefit Managers to Lower Costs
Date:6/1/2011

ies delegate to their staffs the collection and communication of the information the RBM requires, and the study calculates the time and cost involved in responding to and addressing the requests. For a population of 100,000 insured individuals, the study estimates that RBMs shift costs of $182,066 onto physicians and their staffs. When scaled up to the approximately 88 million Americans currently covered by private health plans with RBMs, the model suggests 28 percent  of the projected RBM-related savings are shifted to providers, costing them approximately $160 million per year.  Indirect costs associated with RBM actions include decreased productivity resulting from diagnosis without imaging, delays in the provision of needed imaging services and disease progression that could have been prevented or delayed by using diagnostic imaging to determine an appropriate patient treatment course.

While Lee states, "Our conclusion that RBMs may increase rather than decrease cost is based on parameter values used in a simulation model that have not yet been substantiated," he notes there is a growing body of evidence that prior-authorization programs for drugs and other health care services are associated with both cost shifting and added costs to the health care system overall.  Specific to Medicare, Lee contends that an RBM prior authorization program would also likely result in a cost shift to private payers, as Medicare has fixed rates.

Clinical decision support tools, the study's authors contend, are one option for reducing cost shifting caused by RBMs. Similar to RBMs, they provide feedback on the appropriateness of the imaging study being ordered.  Unlike RBMs, decision support tools do not approve or deny requests; rather they provide appropriateness information electronically and on a real-time basis.

Commenting on the Lee, Rawson, Wade RBM study, Liz Quam, the co-founder of the Imaging e-Ordering Coalition, which represents
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SOURCE GE Healthcare
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