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CEI's membership includes radiologists and other medical professionals,members of the business community interested in abating escalating healthcarecosts, and other interested Texans. The group will push for legislation in theupcoming Texas legislative session to ensure that specific diagnostic imagingservices in the state are safe, appropriately prescribed and performed, andcost effective.
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The group will focus its efforts on magnetic resonance imaging (MRI),computed tomography (CT) and positron emission tomography (PET). CEI's scopedoes not include X-rays, ultrasound or mammography.
Key issues of concern to the coalition include:
Over-utilization
Healthcare costs have skyrocketed in recent years, and expenditures fordiagnostic imaging services have significantly outpaced the rate of growth forhealthcare overall and the U.S. economy as a whole.
The growth in the number of imaging equipment installations has also beensignificant. For example, ten years ago, Travis County and the threesurrounding counties had fifteen CT, MRI and PET units in operation. Today,this same region of Texas has over 110 units.
Understanding what forces are fueling this dramatic growth is importantnot only for patient safety but also for fiscal responsibility. One of thepossible causes for the rise in utilization is the increase in physicianownership of imaging equipment, leading to so-called self-referral. Whilethere is compelling evidence from other states that self-referral leads toover-utilization -- self-referral has, in fact, been banned in at least 23states -- no accurate assessment of the problem has yet been performed inTexas. Data collection and analysis are the only way to determine the extentto which over-utilization fueled by self-referral is a problem in Texas.
The Coalition for Ethical Imaging is advocating a study by the Departmentof State Health Services that will compare the rates at which diagnosticimaging services are prescribed by physicians who have a financial interest inimaging equipment compared to rates for physicians of the same specialty whohave no financial interest in such equipment.
Accreditation of advanced imaging facilities and registration of equipment
Radiology patients deserve safe, high-quality imaging. In fact, patients'lives and their well-being depend on the skill and expertise of the imagingtechnologist, and appropriate and safe operation of the imaging equipment.
Currently in Texas, accreditation of imaging facilities is voluntary. CEIsupports the development of a mandatory registration and accreditation systemthat would ensure that CT, MRI and PET services are provided by licensedprofessionals using equipment that is well-maintained and periodicallyinspected to be sure it is in safe, working condition.
Disclosure
Several states require disclosure of ownership or leasing of imagingequipment and facilities, including Arizona, Connecticut, Delaware, Hawaii,Kansas, Oklahoma and Pennsylvania. Unlike these states, there are norequirements in Texas for physicians to disclose to patients that they have afinancial interest in the imaging centers/equipment to which they arereferring. CEI supports disclosure to patients when this situation occurs inwhich there is an inherent conflict of interest between a physician's duty toprovide the most appropriate care to his/her patient vs. the physician'spersonal financial gain.
Transparent billing
The coalition is in favor of full disclosure of fees for imaging services.Often, when an imaging test is performed by a non-radiologist, routine"mark-ups" are added to the patient's bill. The coalition believes thatpatients should be informed if a healthcare provider bills for but does notperform the imaging service. Further, the coalition believes that healthcareproviders should disclose the amounts charged for the technical component ofthe service (maintenance of equipment, overhead, etc.) and for theprofessional interpretation component (the fee for the radiologist tointerpret the study). The patient would then also know if a trainedradiologist performed the service and if there is a "mark-up" applied to thebill.
The Coalition for Ethical Imaging will take an active role in the 2009legislative session to educate and advocate for its positions on behalf ofradiology patients throughout the state. Through these efforts, the Coalitionstrives to improve patient safety; ensure quality, consistency and accuracy indiagnostic imaging, and to reign in the skyrocketing costs associated withunnecessary scans that lead to financial gain of the equipment owner.Contact: Meg Meo, 512-494-2867, [email protected] or Carrie Simmons, 512-494-2870, [email protected]
SOURCE Coalition for Ethical Imaging
