Reduction of Inappropriate Imaging Procedures for Pain Improves Savings

Inappropriate imaging accounted for more than 20% of annual imaging costs for patients with  uncomplicated low back pain, nontraumatic knee pain, or nontraumatic shoulder pain, according to a study published online in the International Journal for Quality in Health Care.

“Reducing inappropriate imaging procedures can lead to substantial savings through the elimination of unnecessary and low-value procedures,” researchers wrote.

The findings stemmed from a retrospective analysis of claims data for commercially insured patients in Massachusetts with magnetic resonance imaging (MRI) or X-ray claims for uncomplicated low back pain, nontraumatic knee pain, or nontraumatic shoulder pain in 2010 and 2013. Participants were adults with no chronic conditions or prior management for the indication in the year preceding the initial visit. Imaging that took place within 30 days of the office visit was deemed appropriate or inappropriate by researchers based on American College of Radiology imaging guidelines.

During 2010 and 2013, more than 60% of lumbar spine MRIs and more than 30% of MRIs for shoulder and knee pain were inappropriate, according to the study. Patients who underwent inappropriate imaging had significantly lower rates of surgical procedures within 90 days of imaging compared with patients whose imaging was appropriate. 

“Increased awareness of and adherence to best practice guidelines should be a focus of efforts to cut waste in our healthcare system,” researchers advised.

—Jolynn Tumolo

Reference

Flaherty S, Zepeda ED, Mortele K, Young GJ. Magnitude and financial implications of inappropriate diagnostic imaging for three common clinical conditions. International Journal for Quality in Health Care. 2019 January 23;[Epub ahead of print].