Overuse of imaging adds to rising healthcare costs

A lengthening roster of digital imaging modalities, duplicative use of new and older technologies, and growing consumer demand are driving up U.S. healthcare costs significantly, according to a report released Oct. 15 by the Blue Cross and Blue Shield Association (BCBSA).

The report said U.S. diagnostic imaging costs are expected to reach as high as $100 billion annually by 2005, up from about $75 billion just three years ago.

The Blues say their companies across the country are developing innovative collaborations with physicians and hospitals that focus on the most efficient use of high-cost medical technology while safeguarding access to needed services.

"While diagnostic imaging technology is one the most important advancements to healthcare in the past quarter-century, it is also the most expensive technology," said Dr. Allan Korn, BCBSA's chief medical officer.

One of the critical questions before healthcare is how to ensure access to this technology while keeping it affordable, he said.

According to the report, demand may be driven in part by the development of better, less invasive technology. Consumer demand for new technology is high even when it is not clinically indicated.

While more new procedures and modalities are added to the healthcare system, older procedures and equipment are not replaced. Increasing costs and utilization of these new technologies, coupled with growth in older technologies such as x-rays and ultrasound, suggest duplicative use, the report said.

There is also a strong incentive to perform more tests to help pay for the high initial cost of the newer technology.

The American College of Radiology generally concurred with the report, stating in response, "We agree with the conclusion stated in this publication and are currently engaged in collaborative efforts with major private and public payers to evaluate new imaging technology ... and educate referring physicians and patients about appropriate utilization of diagnostic imaging examination."

The ACR added that there has recently been a striking increase in the number of complex, high-cost imaging exams performed by nonradiologists, a trend driven by suppliers who are developing and marketing imaging equipment for use in nonradiologist physician offices.