Physician Self-Referrals Can Hurt Radiology

August 11, 2011

Cuts to reimbursement payments are looming thanks to health care reform measures. No doubt, they have you and other specialty providers scrambling to identify strategies to compensate for the lost revenue.

Cuts to reimbursement payments are looming thanks to health care reform measures. No doubt, they have you and other specialty providers scrambling to identify strategies to compensate for the lost revenue.

For some physicians - those who either own or have a vested financial interest in imaging equipment - self-referring patients could be a convenient way to off-set any drops in reimbursement. But, according to one radiologist, the practice should be stopped because it hurts radiologists in other health care settings.

“Physician-owned imaging equipment diverts dwindling health care resources especially away from non-profit hospitals that still scan the poor and indigent but no longer get the revenue from the insured patients,” said Sidney Roberts, M.D., president of the Texas Radiological Society and radiation oncologist at the Arthur Temple, Sr. Regional Cancer Center. “This drives up the cost of care for everyone.”

Some in health care support self-referral both as a convenience for patients and as a way to pre-authorize more imaging studies. It’s a false argument, though, Roberts said. Diagnostic imaging studies are rarely conducted the day they’re ordered, and there is no guarantee the location to which a patient is referred will be more easily accessible on another day than a hospital or imaging center.

Curtailing physicians’ ability to self-refer for imaging studies will require national buy-in, he said.
“Self-referral needs to be addressed on a national level rather than individual states enacting legislation in a piecemeal way,” he said. “The federal government has a role to play in banning the practice.”