Self-Referral: Scope and Implications

Self-Referral: Scope and Implications • May 22, 2013 • David C. Levin, MD, FACR • Online

Self-referral has been a threat to radiologists for almost as long as the field has existed. A large amount of research has been done on its effects on utilization and costs of imaging. Virtually all the evidence has shown that self-referral inevitably leads to both higher utilization and higher costs. Radiologists who want to lead the fight against it need to know that evidence.

In this session, we will briefly review some of the most important studies that have been done on the effects of self-referral. Unfortunately, the policymakers in Congress, CMS, MedPAC and other federal agencies have so far been unwilling to take action against this abuse. It seems to be too much of a political hot potato. But interestingly, some state governments and payers have taken action. The webinar will also discuss these actions, some of which have been effective.

Practice leaders will benefit from familiarity with this issue, since it is likely to come up at almost any time and anywhere, including in your hospital. To have any hope of convincing state legislators, payers or hospital administrators to do something meaningful to limit self-referral, one must have knowledge.

Learning Objectives:

  1. Recognize the evidence showing the relationship between self-referral and overutilization of imaging
  2. Identify the steps some states and local payers have taken to restrict self-referral in imaging
  3. Consider ways in which you can combat self-referral in your local area
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