Physicians' utilization and charges for outpatient diagnostic imaging in a Medicare population

Patients may undergo more diagnostic imaging tests at a greater cost if their physicians do the tests in their office (self-referral) rather than referring the patient to a radiologist. A study of 174,800 claims submitted to the United Mine Workers of America Health and Retirement Funds within a two-year period found that doctors who did the procedures themselves were much more likely to order the test. The average cost of each test performed in the doctor's office was 1.6 to 6.2 times the cost of the test performed by a radiologist. There has been much in the media about physicians who refer patients to clinics in which the physician has a financial interest. These physicians may order more tests, but there is no evidence that the greater use of diagnostic tests has improved the health of their patients. To reduce health care costs, third-party payers may reimburse self-referring doctors at a lower rate.