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Question of the Day
Insurers will certainly take a close look at the recommendations, but what they do may be limited. That’s because most of the questionable tests and treatments in the lists don’t particularly stand out in the avalanche of bills processed daily by insurance companies.
Take a recommendation for no annual EKGs for low-risk patients with no heart symptoms. Dr. John Santa, director of the Consumer Reports Health Ratings Center, said he used to routinely order EKG’s when he was a general adult medicine practitioner. EKGs cost $50 to $60. A medical assistant would do the tests, and it would take Santa just a couple of minutes to read them. Yet 2 percent to 3 percent of his income came from EKGs, enough to make a difference in a tight year.
“It’s very difficult for an insurance company to tell the difference when an EKG is being used as a diagnostic tool and when it is being used as a screening test,” said Santa. “It would probably cause more trouble for insurance companies.”
The medical groups that participated are: American Academy of Allergy, Asthma & Immunology; American Academy of Family Physicians, American College of Cardiology, American College of Physicians, American College of Radiology, American Gastroenterological Association, American Society of Clinical Oncology, American Society of Nephrology, and American Society of Nuclear Cardiology.
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