Medicare and its beneficiaries could save $13 billion to $24 billion between now and 2020 if radiology benefits management (RBM) programs were adopted by Medicare, according to a study commissioned by Magellan Health Services.
The study was conducted by Milliman, an independent actuarial and consulting firm. The review aggregated results from two RBM vendors, and used the experience for 10 Medicare Advantage clients to develop a savings projection.
The study estimated that the total allowable charges associated with advanced diagnostic imaging services will be approximately $111.6 billion from fiscal year 2011 through fiscal year 2020. It found that if RBM programs were implemented in fiscal year 2012, the program could generate $13 billion to $24 billion in savings by 2020.
The study assumes that the performance of RBM programs was consistent with the Medicare Advantage experience, according to Magellan. Savings would be shared between the beneficiary through lower cost sharing and the fee-for-service Medicare program.
Medicare currently restricts the use of prior authorization programs for the Medicare fee-for-service population, Magellan said.
