Medical Imaging Efficiency: Avoiding Unnecessary Scans
More scans do not equal better care. Learn how CMS measures whether hospitals are appropriately using MRIs and CT scans without exposing patients to unnecessary radiation or costs.
Why "More" Isn't Always "Better"
Medical imaging technologies like MRIs, CT scans, and mammograms are miraculous tools that save lives by diagnosing diseases early. However, there is a growing problem in healthcare: overutilization. Ordering tests that aren't medically necessary doesn't just waste money—it can actively harm patients. That is why the Centers for Medicare & Medicaid Services (CMS) tracks Medical Imaging Efficiency.
The Hidden Risks of Unnecessary Imaging
When hospitals overuse imaging, it creates several risks for the patient:
- Radiation Exposure: While MRIs do not use radiation, CT scans do. Unnecessary CT scans expose patients to radiation that, over a lifetime, can slightly increase the risk of cancer.
- False Positives: Scans often pick up harmless, incidental "spots" or anomalies. This can lead to severe patient anxiety, further unnecessary testing, and even invasive biopsies that were never needed.
- Financial Burden: Imaging is expensive. Unnecessary scans drive up healthcare costs and out-of-pocket expenses for patients.
What Specific Metrics Does CMS Track?
CMS looks at billing data to see if a hospital's outpatient department is following clinical best practices. Two of the most closely watched metrics are:
Sometimes, doctors order a CT scan "without contrast" and then immediately order another one "with contrast." While sometimes necessary, clinical guidelines state that for most conditions, a single scan with contrast is enough. High rates of "double scanning" usually indicate inefficiency and unnecessary radiation.
Lower back pain is one of the most common medical complaints. Guidelines recommend physical therapy, medication, and time before getting an MRI, because most back pain resolves on its own within a month. CMS tracks how often hospitals rush to do an MRI on a patient with lower back pain before trying these initial treatments.
Frequently Asked Questions (FAQ)
Ensure you are getting the right care, not just more care. Compare hospitals based on their Medical Imaging Efficiency scores.
View State Rankings