Imaging Self-Referrals Don't Reduce Sick Days, Costs

A controversial practice in which physicians self-refer patients for imaging tests with the doctors' own equipment does not result in shorter length of illness.  And rather than reducing costs, the cost per episode of care generally averages 4% to 10% higher when the physician self-refers a patient.

Those are findings from one of five reports on self-referral imaging published in the December issue of Health Affairs. The articles question current policy and practice that allow physicians to refer their patients for testing with imaging devices they themselves own.

The first report isby Danny Hughes, assistant director for research at the American College of Radiology, with ACR researchers Jonathan Sunshine and Myrthreyi Bhargavan.

The authors say their results strenuously refute claims by some physician groups that self-referral, which can allow same-day service as the visit with the physician, results in a quicker diagnosis, and thus keeps cost of care lower and speeds patient recovery. In fact, the authors suggest, the practice leads to more testing, and radiation exposure, which carries its own set of hazards.

"In our 20 analyses, 13 showed significantly higher costs with self-referral, and only one showed a significantly lower cost," the authors said.

Additionally, the authors found that the cost of the imaging procedure itself were on average 27% to 40% higher when the test was self-referred, and non-imaging costs were not lower.