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Audiotape
and written materials of
AIS's audioconference on
June 15, 2004 |
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Controlling
the Soaring Costs of Medical Imaging
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Find
out what approaches health plans are taking and with
what results to cope with the rapidly escalating costs
of medical imaging.
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| Sponsored
by Atlantic Information Services, Inc., publisher of Managed
Care Week, the leading newsletter for the health plan industry
since 1990. |
Ten years
ago, medical imaging including magnetic resonance imaging
(MRIs), body scans and computed tomography imaging (CT scans)
wasn't even on the radar screen for most health insurers.
In 2004, it's one of the highest-cost items in a health plan's
medical budget, and also one of the fastest growing.
Booz Allen
Hamilton projects that spending on diagnostic imaging could
grow 28% by 2005, with utilization growing by 9% per year.
The explosion
in imaging costs is driven by a number of factors: high patient
demand for the newest diagnostic tests, physicians eager to
use the most effective technologies, and possibly even some
providers who may boost utilization to help pay off investments
in high-tech equipment. Compounding the problem: all too often
physicians may not have adequate controls on the number of high-cost
imaging tests they are ordering.
To get
a handle on out-of-control imaging costs, health insurers are
employing a wide variety of strategies, including patient and
physician education, targeted copays, and mandatory utilization
review. When you listen in, you'll hear two of the industry's
experts describe which are working? How well? Under what circumstances?
You'll
get detailed answers to questions such as:
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What
medical management and education strategies are being used
to slow the rate of increase in imaging costs?
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Which
techniques have produced the greatest success? Which have
resulted in the least pushback from providers and patients?
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What
factors are driving the growth of imaging costs?
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How
can you develop a strategy to reduce unnecessary imaging utilization,
while maintaining and in fact encouraging appropriate
usage?
Speakers
Thomas G.
Dehn, M.D., FACR, Executive Vice President and Chief Medical Officer,
National Imaging Associates, Inc.
Dr. Dehn was named by Diagnostic Imaging magazine as one
of the nation's top 20 most influential people in radiology. He
recently served as chair of the American College of Radiology's
Task Force on Managed Care. Dr. Dehn served on the clinical faculty
of the Joint Commission for the Accreditation of Healthcare Organizations,
and was the author of several of the earliest articles published
on quality assurance in radiology. Dr. Dehn also participated actively
in the development of the Medicare Peer Review Program and served
as the organization's national president for several years. In that
capacity, he often participated in congressional hearings on the
cost and quality of health care and gained considerable knowledge
of the evolving role of managed care at a time when it was still
in its infancy. Dr. Dehn attended Marquette School of Medicine and
completed his residency in Diagnostic Radiology at the Medical College
of Wisconsin.
Edgar R.
Black, M.D., Vice President and Chief Medical Officer, Excellus
Blue Cross Blue Shield's Rochester, N.Y. Region
Dr. Black's roles include quality management/improvement and
technical assessment guidelines. He joined Excellus as an associate
medical director in July 1997. A specialist in internal medicine
and health services research, Dr. Black received his medical degree
from the University of Pennsylvania and completed his residency
and fellowship education at the University of Rochester's Strong
Memorial Hospital, with which he was affiliated for more than 15
years. He has also worked with colleagues in the Rochester area
to develop diagnostic testing strategies for common problems in
primary care.
Moderator:
Jill Brown, managing editor of AIS's industry-leading Managed
Care Week.
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Health
plan operating and financial executives, medical directors, contracting
directors, utilization review directors, provider relations directors,
benefit structure designers
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Medical
group administrators, contracting directors
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Hospital
contracting directors, financial managers, quality assurance directors
and medical directors
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Imaging
company executives
- Benefit managers
for large employers
- Directors of
freestanding imaging clinics
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on strategies for controlling the escalating costs of medical imaging.
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