PRESS RELEASE: MediGold Selects Care to Care to Manage Imaging Benefit
New York, NY – Mount Carmel Health Plan (MediGold), an Ohio-based Medicare Advantage plan, has selected Care to Care, LLC as its partner to manage outpatient advanced imaging for its members, including magnetic resonance (MR), computed tomography (CT), positron emission tomography (PET) and nuclear cardiology. Care to Care will help MediGold ensure clinically appropriate imaging is performed through the use of its proprietary, evidence-based clinical criteria. The company will work collaboratively with MediGold physicians to promote the safe use of advanced imaging and provide an objective basis for informed clinical decision making.
The United States spends more than $100 billion annually on diagnostic imaging. Health insurance plans’ imaging costs have grown about 10-18 percent annually. Factors contributing to this significant growth in advanced-imaging utilization over the last decade include: an aging population, direct-to-consumer marketing, defensive medicine, and physician self-referral. According to one study, as much as 30-to-40 percent of advanced-imaging procedures paid for by Medicare are clinically inappropriate. The Centers for Medicare and Medicaid Services (CMS) reports more than a two-fold increase in Medicare imaging payments over a recent eleven-year period—from $6.8 billion in 1995 to $14.1 billion in 2006. An article in the journal Radiology reports a 500-percent increase in emergency room visits that include CT utilization—from 2.7 million in 1995 to 16.2 million in 2007.
MediGold is a physician- and hospital-founded, not-for-profit insurer serving Medicare eligible beneficiaries in Ohio. The plan wants its members to receive the right test at the right time. “MediGold is making every effort to ensure that every advanced diagnostic imaging study our members receive is clinically appropriate and safe. Our goal is to maximize the value of advanced diagnostic imaging, to keep healthcare affordable, and to limit our
