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Morning Read: Radiologists look to clamp down on doc self-referral

Highlights of the important and the interesting from the world of healthcare: Radiologists look to clamp down on doc self-referral: Good move by the American College of Radiology in requesting the GAO study how physician self-referral affects medical imaging and radiation  costs in Medicare. Evidence shows that when  physicians have a financial interest in doing […]

Highlights of the important and the interesting from the world of healthcare:

Radiologists look to clamp down on doc self-referral: Good move by the American College of Radiology in requesting the GAO study how physician self-referral affects medical imaging and radiation  costs in Medicare. Evidence shows that when  physicians have a financial interest in doing so, they make referrals for imaging services about twice as often as doctors who don’t, the ACR says. That obviously adds lots of unnecessary costs to U.S. healthcare. Two chairs of House committees have called on the GAO to conduct the study, which amounts to a smart move by the American College of Radiology.

If there is a strong correlation between overuse of imaging and self-referral, as it appears, then radiologists make their profession look a lot better if they strongly speak out  against self-referral. The decision by the ACR’s leadership to take a stance against self-referral likely antagonized some honest (and not-so-honest) doctors who engage in the practice, but give the leadership credit for having the courage to do it. Self-referral appears to be a practice that is too easily manipulated to escape strong regulation–and that’s assuming that it shouldn’t be eliminated entirely.

Examining world death rates: Men in Iceland and women in Cyprus have the lowest mortality rates in the world, according to a study in the British medical journal Lancet. In a survey of 187 countries, spanning 40 years and using records from government registries, censuses, household surveys and other sources, the United States didn’t fare so well: No. 49 for women and No. 45 for men. The findings show yet again, for all of our spending, we’re not getting results.

“The U.S. is definitely on the wrong trajectory,” said  one of the study’s authors. “(The US) spends the most on health out of all countries, but (it) is apparently spending on the wrong things.”

Unfortunately researchers weren’t sure why some countries–such as Australia, Italy, South Korea, Chile, Tunisia and Algeria–were able to cut their death rates by more than two percent per year. They “guessed” that the improvements were related to better policies on things like tobacco control and road accidents.

Beware balance billing: The savvy healthcare consumer needs to be on the lookout for balance billing–when a health provider bills you the difference between what they charge for a procedure and the amount the insurer will pay them. It’s a “controversial and sometime illegal” practice, and most states  have passed laws making balance billing illegal within an insurer’s medical network. But some providers apparently still do it. In cases of balance billing, your insurance company is  your best friend, or the “enforcer,” as one patient advocacy expert says.  Generally, balance billing results from getting care out of network, but even then your insurer may cover some of the bill if you’re in a PPO.

Photo from flickr user habi

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