Controlling imaging costs

David E. Williams at the Health Business Blog says that health plans are starting to control diagnostic imaging costs by requiring prior approval for outpatient CT and MRI scans.

Blue Cross Blue Shield of Wisconsin is the latest health plan to announce this policy, according to the Business Journal of Milwaukee. They will be using American Imaging Management (AIM) to help on this front. ...the plans will disallow requests that don't conform to American College of Radiology guidelines.

Williams recommends:

Physicians could save themselves the trouble by following the guidelines themselves or relying on a system such as SafeMed that can support their decision making and keep the AIM folks off their backs.

Link: Health business blog: Ratcheting down imaging costs

Comments

[HxTI]

A recent study by HealthLeaders predicts that radiology utilization management is the next "cost battlegound" between health plans and providers. It doesnt have to be this way. Other radiology utilization management solutions are coming to market that are more provider and patient-friendly that cut radiology spending without causing the payer-provider friction that the radiology benefit management firms are seeing.