Imaging not a major driver of healthcare costs, data from value-based commercial plan show
Imaging is not a significant driver of healthcare costs, data from a value-based commercial insurance contract show.
Radiology has been a common target in such efforts to reduce spending and prevent healthcare waste. Researchers recently aimed to better understand whether this scrutiny is warranted, detailing their work Jan. 10 in Pediatric Radiology [1].
“Our analysis of claims data from a single large commercial value-based insurance plan suggests that medical imaging expenditures are not a major driver of cost in the pediatric population, with medical imaging only contributing…0.2% of the total healthcare spend,” Lane F. Donnelly, MD, with the Department of Radiology at the University of North Carolina School of Medicine, and colleagues concluded. “Also, medical imaging expenditures for pediatric patients are significantly less than those in the adult population studied,” they added.
For the study, researchers reviewed all claims at a single healthcare system for calendar years 2021 and 2022, calculating per-member expenditures. Children made up about 20% of members in the value-based plan and 21% of member months but only about 8%-9% of expenditures. About 2.9% of the total pediatric spend was on imaging, with per-member spending on the service seven times greater for adults than kids.
A key takeaway? “Healthcare organizations that care for both adult and pediatric populations in value-based contracts would be served well to look at contributing expenditures separately in children as compared to adults and design their cost reduction strategies in children independently from those targeted to reduce costs in adult care,” Donnelly and co-authors suggested.
Read more about the study results, including potential limitations, at the link below.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.