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Milliman Study Validates
Savings Generated
by MedSolutions’ Radiology Management Programs
NASHVILLE, Tenn. - June 20, 2007 - A
report by a Milliman team released today by MedSolutions documents the
savings generated by the MedSolutions radiology management program in 2005
and 2005 for an HMO. Believed to be the first study to demonstrate cost
savings fro radiology management with statistical analyses, the report
shows per member per month (PMPM) savings for a program that managed three
high technology diagnostic imaging services covered by MedSolutions:
computerized tomography (CT), magnetic resonance imaging (MRI), and
positron emission tomography (PET).
"The reductions compared to trend generated
for the HMO after MedSolutions' involvement are impressive; especially in
light of double-digit inflation for high-tech imaging studies," says
Kathryn Fitch, RN, MEd and principal at Milliman. "We estimate that,
compared to costs based on historical trends, the HMO's allowed PMPM
experience was lower during the MedSolutions management period by 30
percent during 2Q05 - 4Q05 and 42 percent during 1Q06 - 3Q06."
Industry experts attribute about 10 percent of
the total commercial medical spend to radiology, and the growth in volume
has been significant. According to the Blue Cross Blue Shield Association
(2006), over the course of three years (1999 to 2001) the number of MRI
scans rose by more than 45 percent. Diagnostic imaging services paid under
the Medicare Physician fee schedule grew more rapidly than any other
physician category between 1999 and 2003 -- at 45 percent more than twice
the growth for all physician services.1 The primary drivers of
trends in imaging costs include increased inappropriate and redundant use
of imaging, increased sales and installation of imaging scanners,
development of new high-tech imaging and direct marketing to consumers.
MedSolutions' radiology management programs
review the appropriateness of imaging studies and avoid redundancy through
a pre-authorization process, and they control reimbursement through direct
contracting with imaging providers. Most radiology management companies
also focus on improving care quality by techniques such as professional
accreditation requirements for imaging providers and privileging programs
designed to limit patients' access to imaging studies provided by
non-radiologists.
"Milliman's statistical approach provides a
high level of credibility because it considers the fluctuation of trend
and the data available, which included a gap between the baseline and
operational periods," states Curt Thorne, president and CEO of
MedSolutions, a trusted partner for radiology management to the nation's
leading health plans. "This study further validates the cost savings that
MedSolutions can bring to its customers."
View Report
About MedSolutions
MedSolutions
specializes in managing radiology services for national and regional
health plans as well as federal and state government agencies, maintaining
management contracts for nearly 25 million individuals nationwide. The
company leverages sophisticated analytics, personalized call center
operations and extensive radiology care management experience to provide
the most innovative, cost-effective radiology management solutions in the
industry. Visit
www.medsolutions.com.
About Milliman
Milliman, serves business, financial, government, and healthcare
organizations with expertise in managing and analyzing financial and other
risk. Milliman employs more than 900 qualified consultants and actuaries.
The Milliman Care Guidelines are the leading evidence-based
clinical guidelines used by managed care organizations. The company is
owned only by its principals, not by an insurer, outsourcing company, bank
or accounting firm. Milliman does not sell insurance or benefits programs
or broker deals. Visit
www.milliman.com.
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