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Health Policy and Practice |
1 From the Department of Radiology (D.R.E.) and Lynn Sage Breast Center (C.H.), Northwestern Memorial Hospital, 676 N St Clair St, Suite 800, Chicago, IL 60611; Midwest Cultural Center, Chicago, Ill (P.M.A.); and Department of Radiology, Baylor School of Medicine, Houston, Tex (L.A.V.). Received July 26, 2000; revision requested September 7; revision received October 4; accepted October 31. Address correspondence to D.R.E. (e-mail: denzmann@mednet.ucla.edu).
PURPOSE: To perform a financial analysis of mammography services to determine whether the key underlying economic drivers of this service are aligned with the public’s expectations.
MATERIALS AND METHODS: The financial status of mammography services at seven university-based programs was assessed by using an extensive financial survey encompassing revenue, direct and indirect costs, and volume data for 1997 and 1998. At one of the institutions, an activity-based costing analysis was performed by procedure type: screening mammography, diagnostic mammography, breast ultrasonography, interventional procedures, and review of outside mammograms.
RESULTS: All seven institutions incurred losses in the professional component of mammography services. The underlying financial problem was a negative contribution margin (total mammography revenues minus direct expenses). The driver of the financial loss was the volume of diagnostic mammograms, which generated a loss per procedure. Diagnostic mammogram volume drove the mammography full-time equivalent count (P = .039) and was highly and negatively correlated with contribution margin (P < .001).
CONCLUSION: The reimbursement rate for mammography procedures, especially diagnostic mammography, needs to be increased to reflect the current reality of the resources necessary to maintain the accessibility and accuracy of this evolving mix of clinical services.
Index terms: Breast radiography, quality assurance • Breast radiography, utilization, 00.112, 00.126, 00.1298 • Economics, medical • Radiology and radiologists, socioeconomic issues
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