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MedSolutions First to Offer Service for Analyzing Radiology Costs from Claims Data Las Vegas, Nevada, June 10, 2005 -- MedSolutions announced today it is the first radiology management company that can accurately predict radiology ordering patterns of individual physicians using only a health plan's historical claims data in many cases. The new technology, called Predictive Radiology Intelligence™, will help health plans better understand their radiology costs and implement appropriate cost-reduction strategies. A rapid expansion of complex imaging technologies and widespread variation in physician ordering behavior for high-tech radiology are two of the primary reasons that radiology is the fastest growing cost for health plans. "Our market research shows that payers want data-driven solutions to their imaging cost problems," said Curt Thorne, MedSolutions' chief executive officer. "At the same time, current radiology management philosophies are inadequate for keeping pace with dramatic changes in equipment and the business of radiology. Predictive Radiology Intelligence is a non-invasive, data-driven approach that provides a health plan a much more detailed picture of its radiology costs and where to find savings." Using complex mathematical algorithms and statistical analysis encompassing extensive historical data, Predictive Radiology Intelligence analyzes claims data to predict not only if physicians order radiology inappropriately - based upon research and evidence-based standards - but in what clinical circumstances an individual referring provider is most likely to order inappropriately. Each inappropriate order represents a savings opportunity for a health plan. "For example, a primary care physician may order an MRI of the low back appropriately every time," said Gregg Allen, M.D., MedSolutions' chief medical officer. "That same physician may order a CT of the abdomen inappropriately 75 percent of the time. Predictive Radiology Intelligence can identify these circumstances without an aggressive pre-certification program." Current radiology management practices center on pre-certification, which requires physicians or their office staff to call a radiology management company for approval before referring a patient for radiology. Using its evidence-based standards, the radiology management company certifies whether or not the request is appropriate. Pre-certification is a proven technique for decreasing radiology costs. However, physician networks have resisted the "guilty until proven innocent" underpinnings of pre-certification programs, creating one of the primary reasons payers may not choose to use this technique. "Predictive Radiology Intelligence allows MedSolutions to focus only on those referrals which are likely to be inappropriate, which ushers in the next generation capability in radiology management," Thorne said. "We can marry the Predictive Radiology Intelligence technology with a variety of funding options and intervention strategies to meet the unique needs of an individual payer." About MedSolutions MedSolutions specializes in managing radiology services for nationally recognized managed care organizations and maintains management contracts for 11 million members nationwide. The company leverages extensive radiology care management experience to provide the most innovative, cost-effective radiology management solutions in the industry.
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