Medical imaging promises to transform the practice of medicine, but the techniques, which are increasing dramatically in cost, must be used cost-effectively, according to an interview with Bill Clarke, a former executive with GE Healthcare, and E. James Potchen, the chairman of radiology at Michigan State University, published in Health Affairs. Although the United States has more imaging equipment per capita than in most western European countries, it is not necessarily overspending on imaging, says Clarke. Costs are increasing because innovation is allowing the technology to be pushed further, and it will be incumbent on the industry to demonstrate the value of molecular imaging to payers by doing high-quality clinical trials. He also endorses the “coverage with evidence development” approach taken by CMS for positron emission tomography scans, which covers certain oncological applications of PET scanning on an interim basis while data are being collected on their effectiveness.
Potchen recommends that CMS pay only for images read by those who have demonstrated a certain level of skill in doing so. “Whoever does the job well should be paid,” Potchen says, regardless of whether he or she is a radiologist, a cardiologist, or a member of some other specialty. “The trouble is, [imaging is] so profitable that many people with less-than-adequate knowledge enter the business because there are no restrictions on who does it.”
