Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions

What GAO Found

GAO.gov: 9/28/12

From 2004 through 2010, the number of self-referred and non-self-referred advanced imaging services–magnetic resonance imaging (MRI) and computed tomography (CT) services–both increased, with the larger increase among self-referred services. For example, the number of self-referred MRI services increased over this period by more than 80 percent, compared with an increase of 12 percent for non-self-referred MRI services. Likewise, the growth rate of expenditures for self-referred MRI and CT services was also higher than for non-self-referred MRI and CT services.

GAO’s analysis showed that providers’ referrals of MRI and CT services substantially increased the year after they began to self-refer–that is, they purchased or leased imaging equipment, or joined a group practice that already self-referred. Providers that began self-referring in 2009–referred to as switchers–increased MRI and CT referrals on average by about 67 percent in 2010 compared to 2008. In the case of MRIs, the average number of referrals switchers made increased from 25.1 in 2008 to 42.0 in 2010. In contrast, the average number of referrals made by providers who remained self-referrers or non-self-referrers declined during this period.  Read more