Anna Wilde Matthews reports in the Wall Street Journal on a growing trend: health insurers are taking a page out of Medicare’s playbook and increasing measures to rein in the “skyrocketing costs of imaging scans like MRIs.” In contrast to Medicare’s strategy (confusing rules and recovery audits), private health plans have turned to so-called “Radiology Benefits Managers,” or RBM’s. The RBM’s require doctors to get permission to do a scan before the insurer will agree to pay for it. The concerns about costs are understandable:
Scans have helped drive up health-care costs in recent years. The number of computed tomography, or CT, scans, and magnetic resonance imaging, or MRIs, increased 43% in five years to a combined 96.2 million procedures in 2007, according to IMV Medical Information Division Inc., a market-research firm. Positron emission tomography, or PET scans, more than tripled from 2001 to 2005 to an estimated 1.1 million.
