CHICAGO, March 24, 2011 /PRNewswire/ -- A new program from American Imaging Management (AIM) delivers valuable information to physicians and consumers regarding the price of advanced diagnostic imaging exams and the quality of the facilities where those exams are performed, offering significant cost savings and increased satisfaction.
As consumers assume greater responsibility for health care spending, there is a growing need for information that offers a clearer understanding of the options that exist for them. AIM, a leading specialty benefit management company and operating subsidiary of WellPoint, Inc. (NYSE: WLP), is bringing this information to consumers through OptiNet, the company's member transparency resource. The member-transparency component of OptiNet is initially being used for advanced diagnostic imaging procedures such as CT scans and MRIs that are administered in an outpatient setting.
"Advanced diagnostic imaging exams are very expensive and often patients and their physicians are not aware that price can vary dramatically depending on where the exam is performed," said Brandon Cady, president and chief executive officer of AIM. "We routinely see instances where different facilities located in the same area – with the same type of equipment and the same type of physicians reading the results – have prices that vary by more than a thousand dollars."
In order to promote more informed decision making by patients and physicians, AIM launched the member transparency component of OptiNet as a concierge-type program that delivers pricing and capability information directly to health plan members, using data submitted by health plans and the imaging facilities themselves.
OptiNet operates in tandem with AIM's clinical appropriateness program. When a physician goes through the review process for an imaging exam, AIM provides price and capability information that can be used by the physician to select an imaging facility. After the review process is completed, OptiNet compares the price and capability scoring for the imaging facility selected during the review process with other facilities located in the same geographic area. If the program finds another facility that offers comparable or better capabilities at a lower price, an AIM representative proactively calls the consumer to provide this information to the consumer. While wholly voluntary, if the consumer decides to switch to an alternative imaging facility for the exam, AIM provides assistance in scheduling the service.
"Our program was developed in partnership with or affiliated health plans and empowers consumers by giving them information that they can use to make a decision that's best for them," said Cady. "As employers and health plan members take a greater role in financing their health care, OptiNet represents the type of service that can help promote the affordability of health care services in the United States. Providers should be competing on quality, capabilities and price – and consumers should have easy access to that information."
The OptiNet member transparency tool for CT scans and MRIs is being piloted with WellPoint's affiliated health plan in Indiana within a nine-county Indianapolis market where AIM and the health plan identified a broad cost difference among advanced diagnostic imaging procedures. The cost variance for CT scans was more than $1,000 in many instances, while the variance for more expensive MRI procedures was almost $2,000.
"This program represents and underscores our commitment to helping improve quality and cost effectiveness in the delivery of health care services to our affiliated health plan members," says Anthony Nguyen, M.D., senior vice president of Care Management for WellPoint. "We are excited to be at the forefront of promoting transparency and value across our industry and in empowering individuals to become more informed health care consumers."
In the first two months of the pilot, more than 460 exams were impacted by the OptiNet member transparency program. In these cases, WellPoint's affiliated health plan members in the Indianapolis region voluntarily chose to switch imaging facilities to a high-quality, lower-cost alternative that an AIM representative informed them about using information generated by OptiNet. The average price savings for services that were redirected is estimated to be $1,000 per exam. Affiliated health plan members have reacted positively to the new program and the consumer education and choice it promotes.
Mary Greist, M.D., an affiliated health plan member in Indianapolis and a practicing dermatologist, recently utilized the program's services for an MRI exam that her physician had ordered. The imaging facility selected for Greist was on average $1,200 more than another facility that was nearby and offered similar capabilities. The information that Greist received from the AIM representative was timely and relevant.
"Even as a physician, it's nearly impossible for me to shop around and compare prices [for procedures] and I'm better equipped to navigate the system than most people," Greist said.
After discussing options with the program representative, Greist decided to have the MRI performed at another imaging facility identified by the program. She was pleased with the information and the customer service.
"What was really nice is that [the representative] emphasized it was my choice," said Greist. "She really facilitated [the switch], she didn't just say, 'here's some information that might be of interest to you,' she really helped make it happen." Of the following day's procedure, Greist commented: "I had the scan at 8:00 am, was out the door by 9:00 am, and at my practice by 9:30 am. The whole experience was very satisfactory."
With the growing demands on health care consumers, having accurate, timely and relevant information that can be used to support decision making can be very valuable. AIM's new transparency program offers education that health care consumers can really use.
About American Imaging Management
American Imaging Management, Inc. (AIM) is a leading specialty benefit management company with over 20 years of experience in the radiology benefit management industry. AIM's mission is to make healthcare services more clinically appropriate, safer and more affordable. AIM promotes the most appropriate use of diagnostic imaging through the application of widely accepted clinical guidelines delivered through an innovative platform of technologies and services. AIM pioneered the use of web self-service technology in diagnostic imaging management and has continually integrated technology tools to create a more effective and efficient clinical review processes in support of the physician-patient relationship. AIM also manages a growing platform of healthcare services including cardiac services and specialty pharmaceuticals. Through a commitment to delivering excellence in clinical content, service, innovation and operational performance, AIM has developed a national client base of health plans, and currently provides its services to more than 35 million health plan members. AIM is an operating subsidiary of WellPoint, Inc. (NYSE: WLP; www.wellpoint.com). For more information on AIM, please visit http://www.americanimaging.net.
SOURCE American Imaging Management, Inc.