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Quality improvement program for Medicare could save $433 million in imaging costs

by John R. Fischer, Senior Reporter | January 15, 2021
Insurance X-Ray
R-SCAN could save $433 million spent on imaging annually if applied across Medicare
Providers and radiology practices nationwide could save hundreds of millions of dollars spent on imaging by employing a quality improvement program within Medicare.

The Radiology Support, Communication and Alignment Network (R-SCAN) involves collaboration among referrers, radiologists and patients to ensure imaging is used when appropriate, and is expected to save $433 million in costs annually if used for Medicare patients, according to a new study out of Stanford University.

“This will require ongoing education on evidence-based imaging, led by radiologists for their referring clinician colleagues, and may be facilitated by the implementation of [clinical decision support] tools,” wrote author Max Wintermark, a neuroradiologist in the department of radiology at Stanford, and his colleagues.

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For their study, the team utilized the American College of Radiology’s R-SCAN database, which has information from practices in dozens of distinct projects. With Choosing Wisely and ACR recommendations, they evaluated 4,700 R-SCAN cases from 27 practices between 2016 and 2019. Those involved rely on targeted low-value imaging such as CTA for pulmonary embolism, adnexal cyst imaging follow-up and advanced imaging for lower back pain.

The researchers calculated the proportion of appropriate and low-value studies performed among R-SCAN patients, as well as percentage changes before and after the intervention. They then applied their findings to a 5% sample of Medicare beneficiaries treated in 2017 and found that R-SCAN saved $260,000 over 3.5 months for lesser-value imaging. When they extrapolated the numbers across the entire population, total cost reductions were $433 million annually.

Other institutions in the study include the Harvey L. Neiman Health Policy Institute, NYU Langone Health, Emory University and the Georgia Institute of Technology.

The findings were published in the Journal of the American College of Radiology

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