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Unnecessary Costs

Joe Cantlupe, for HealthLeaders Media, June 13, 2012
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This article appears in the June 2012 issue of HealthLeaders magazine.

Often, physicians order too many MRIs or x-rays in evaluating a patient's hip or knee condition.

When Vanderbilt University researchers tabulated potential unnecessary costs nationwide, it amounted to more than $2 billion per year. Researchers attributed the costs mostly to defensive medicine, with no benefit to patient care.

"That's a lot of money and a real problem, but things can be done to offset that behavior," says Manish Sethi, MD, assistant professor of orthopedic surgery and rehabilitation and lead author of the study.

Bundling is an area that will "force us to be smarter about the tests we order," says Sethi, referring to potential fiscal gains for physicians as well as hospitals if they reduce the waste in spending for MRIs or x-rays. However, Sethi says that he's concerned that will not change "the fears of liability amongst doctors" and, as a result, not reduce costs as many hope.

"It will not dissuade doctors from pursuing tests out of fear of liability," Sethi says. "Rather, it will transfer the costs of such tests to the hospital or medical groups who will now be responsible for these tests under a future bundled payment plan where singular payments are made."