Radiology benefits management (RBM) firm American Imaging Management (AIM) said that its prospective clinical review program for echocardiography has yielded an 18% decrease in utilization since a health plan implemented it in 2009 over a three-state region.
The company said it evaluated a client population of approximately 3 million members over a two-year period in 2009 and 2010 to determine the impact of its echocardiography clinical review program on provider ordering behaviors and utilization patterns.
In addition to discovering savings by reducing unnecessary healthcare spending, the case study found that although appropriate use criteria for stress echocardiography and myocardial perfusion imaging (MPI) are almost identical for clinical scenarios related to coronary artery disease, providers in the focus market tended to refer lower-risk patients for stress echocardiography and higher-risk individuals for MPI, AIM said.
As a result, the program helped to manage stress echocardiography requests based on the clinical characteristics of the patients as presented by ordering physicians, according to the firm.
