Cost Savings

When patients have access to and receive the right scan at the right time, costs are reduced and workers are healthier and more productive. Such savings are often apparent, as when medical imaging replaces surgery, avoids a trip to the catheter lab and reduces hospital stays. Other times, savings are harder to see, as when imaging facilitates disease prevention and early detection and diagnosis, allowing a patients to stay healthy, recover faster, and return to work and their family more quickly.

Imaging can provide cost savings in several ways – by minimizing the occurrence of unnecessary surgeries, avoiding costly disease outcomes, through early detection, reducing hospital stays or using minimally invasive procedures that reduce both operating room time and recovery time.

In addition to reducing time to diagnosis, medical imaging also serves as a gatekeeper for triaging patients for expensive or potentially risky procedures.

Let’s take a look at how the right scan at the right time saves dollars:

• Researchers at Harvard Medical School have demonstrated that every $1 spent on inpatient imaging translates into approximately $3 in total savings and that every $385 spent on imaging decreases a patient’s hospital stay by one day, saving approximately $3,000 per patient.
• According to Medical Expenditure Panel Survey (2004) “the average expense per night for a hospitalization in 2004 was about $3,000 while the median per diem was about $1,800.”

Cardiovascular Disease

• Coronary computed tomography angiography (CCTA) can be used to select patients for cardiac catheterization, and is effective and cost-saving for patients with abnormal imaging results. In one study 32% of patients had potentially obstructive plaque seen on CCTA, requiring catheterization. Selective catheterization based on the results of CCTA resulted in average cost savings of $1,454 per patient.
• The University of Michigan’s Stroke Program showed CCTA saved $2,353 per patient compared to standard catheterization in Journal of Neuroimaging. (October 2008)
• A 2001 study published in Academic Radiology found that increased imaging could save up to $1.2 billion annually in the treatment of stroke patients.

Osteoporosis

• Advances in diagnostic imaging have made it possible to identify bone loss early, before an osteoporotic fracture occurs. A 2005 study published in Osteoporosis International estimated that bone mineral density scanning of an additional one million women in 2001, followed by appropriate osteoporosis therapy, would have averted 35,000 fractures and generated $78 million in Medicare savings by 2003.

Colorectal Disease

• A study conducted by the American College of Radiology Imaging Network and sponsored by the National Cancer Institute found evidence that computed tomographic colonography (a noninvasive imaging procedure) is “approximately as successful” as standard colonoscopy (use of an endoscope to look for irregularities inside the colon) in detecting polyps. Not only is CTC a less invasive diagnostic option, it costs significantly less than the traditional method, according to another recent study published in the American Journal of Roentgenology, showing that “CT colonography…is both a highly cost-effective and clinically efficacious screening strategy for the Medicare population.” The study demonstrated that CT colonography was cost-effective (factoring in both cost differential and life years gained) compared with no screening and compared with optical colonoscopy. Additionally, its ability to simultaneously screen for abdominal aortic aneurysms (AAA) made CT colonography the most cost-effective screening procedure in the study.

Appendicitis

• In 1998, a study by Massachusetts General Hospital set out to determine how the routine use of CT affects patient care and treatment costs for patients with suspected appendicitis. This study showed that CT significantly reduced both the negative appendectomy rate (surgeries in which the patient turns out not to have had appendicitis) and the number of unnecessary admissions for observation, for an estimated savings of $447 per patient.
• In 2002, Bendeck et al. found not only that women had the highest negative appendectomy rate (28%), but that by conducting CT and ultrasound prior to operating, this rate could be reduced to 7% and 8% respectively. In women of reproductive age (16-49), Morse et al. reported a negative appendectomy rate of 42% without preoperative CT compared to 17% with CT. After accounting for patient and insurance company costs, the average estimated savings from preoperative CT was $1,412 per patient.