A new study finds that one in six physicians in 2008 reported that his or her practice owned or leased advanced imaging equipment, adding to concerns of the technology's overuse.
The report, which was funded by the Robert Wood Johnson Foundation, was released last week by the Center for Studying Health System Change (HSC).
According to the study, physician practice ownership or leasing of a broad array of medical equipment, ranging from equipment for laboratory testing to invasive procedures, is quite common.
Policy makers have long been concerned that physicians with ownership or other financial interests in medical facilities and equipment would make more referrals than medically necessary. Since the mid-1990s, the federal physician self-referral law, commonly known as the Stark Act, has prohibited physicians from self-referring Medicare and Medicaid patients to certain health services, ranging from clinical laboratory services to advanced imaging services.
There are numerous exceptions to the self-referral prohibitions, however, most notably if the service is provided within the physician's office or practice.
While previous research on physician self-referral has focused on particular services, such as advanced imaging, there has been little national information about how pervasive physician ownership or leasing of medical equipment is more broadly.
HSC's nationally-representative 2008 Health Tracking Physician Survey asked physicians whether their main practice owned or leased equipment used for:
- laboratory testing, including routine blood work;
- X-rays;
- other diagnostic imaging, such as CT or MRI scans;
- non-invasive testing besides electrocardiograms, or EKGs (e.g. echocardiograms, treadmill, nuclear testing, sleep testing); and
- invasive procedures, such as endoscopy or cardiac catheterization.
Of 2,750 physicians in community-based, physician-owned practices, 25.2 percent reported that their practice owned/leased equipment for laboratory services, 22.7 percent for X-rays, 17.4 percent for advanced imaging, 28.9 percent for non-invasive procedures and 11.4 percent for invasive procedures.
Overall the study found that almost one in seven physicians (13.2 percent) reported that their practice owned or leased three or more types of equipment.
The study was coauthored by HSC Senior Researcher James Reschovsky, HSC Public Affairs Director Alwyn Cassil, and former HSC Senior Researcher Hoangmai H. Pham, MD.
Click here to read more about the study.
