Medicare Claims Indicate CT Scanning Overuse

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Efforts by the Center For Medicare and Medicaid Services (CMS) to discourage health care providers from exposing patients to excess radiation have not been entirely effective. While the agency last year provided hospitals with statistics intended to encourage efficient, safer practices, hundreds of hospitals nationwide continue to perform two CT scans on Medicare outpatients in a single day, CMS records show.

“The overuse of scans has been the subject of growing concern in recent years, but a review of the federal data, focusing on a common procedure performed millions of times a year, offers a rare and detailed snapshot of the problem state by state, hospital by hospital,” write Walt Bogdanich and Jo Craven McGinty in a June 18 article in The New York Times.

imageAmong statistics and observations cited in the article:

  • In 2008—the most recent year for which statistics are available--about 75,000 patients received double scans, one that used iodine contrast to check blood flow and one that did not. Medicare paid roughly $35 million for these scans.
  • Three years ago, more than 80% of hospitals were performing double CT scans on Medicare chest patients on the same day, despite radiologists’ assertion that performing two scans in succession is rarely necessary.
  • Last year, CMS shared data pertaining to double scanning with U.S. hospitals to demonstrate show how they performed relative to each other and to encourage more efficient, safer practices. A review of this data revealed that more than 200 hospitals had administered double scans on more than 30% of their Medicare outpatients — a percentage CMS and radiologists alike deem considers far too high. The national average is 5.4%.
  • Double scanning is more likely to occur at smaller community hospitals than at larger institutions.
  • Double scanning is also common among privately insured patients, who tend to be younger than those who are covered by Medicare.

Next month, CMS plans to release double scanning data for 2009, but those who have seen it—and some who are privy to more recent data—say it is relatively unchanged from 2008 figures.

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