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Related Experiment Videos

Utilization management and noninvasive diagnostic imaging.

Shelley Nan Weiner1, Michael Komarow

  • 1CareCore National, LLC, Wappingers Falls, New York 12590, USA. sweiner@carecorenational.com

Managed Care Interface
|June 9, 2005
PubMed
Summary

Rising health care costs are linked to increased diagnostic imaging. A new precertification program involving radiologists has successfully reduced inappropriate imaging use, promoting cost-effectiveness.

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Area of Science:

  • Health Economics
  • Radiology
  • Medical Imaging Utilization

Background:

  • Healthcare costs in the US are escalating rapidly.
  • Increased reliance on diagnostic imaging significantly contributes to rising healthcare expenditures.
  • There is a recognized need for efficient and cost-effective diagnostic imaging practices.

Purpose of the Study:

  • To describe a program designed to mitigate inappropriate use of diagnostic imaging.
  • To evaluate the effectiveness of a precertification process involving radiologists in controlling imaging costs.

Main Methods:

  • Implementation of a precertification program for diagnostic imaging.
  • Involvement of both community-based and academic radiologists in the precertification process.
  • Focus on optimizing the use of diagnostic imaging services.

Main Results:

  • The described program has demonstrated a reduction in inappropriate diagnostic imaging utilization.
  • The collaborative approach involving radiologists in precertification proved effective.
  • Potential for cost savings and improved resource allocation in healthcare.

Conclusions:

  • A radiologist-involved precertification program can effectively reduce inappropriate diagnostic imaging.
  • Optimizing imaging use through such programs is crucial for cost containment in healthcare.
  • This model offers a scalable solution for managing diagnostic imaging costs nationwide.

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