Nonradiologists’ Financial Interest Drives Up Usage, Cost

Nonradiologist physicians with a financial interest in imaging means were as much as 49 percent more likely to order imaging as those with no financial interest, according to a new study published in the American Journal of Roentgenology.

Mythreyi Bhargavan, PhD, research director for the American College of Radiology, and colleagues modeled a random 5-percent sample of Medicare fee-for-service beneficiaries from 2004 to 2007. Using Ingenix’s Symmetry Episode Grouper software, they compared use of imaging outside of hospitals based on the referring physician’s financial interest in diagnostic imaging, studying 23 combinations of medical conditions and imaging approaches.

“Controlling for patient characteristics, illness severity, and physician specialty likewise had little effect. Physicians who had acquired a financial interest averaged a 49 percent increase in the odds of imaging relative to physicians who had not,” Bhargavan and colleagues wrote.

Physicians with financial interest in one imaging modality used more of that type of imaging as well other modalities, the researchers found - “sometimes much more,” they added. The team also found that the Deficit Reduction Act’s 2007 payment reductions had little impact on imaging use.