New Evidence Links Self-Referral Labs to Increased Utilization, Lower Cancer Detection Rates
Study co-funded by CAP Appears in April 2012 Issue of Health Affairs
April 9—Self-referring urologists billed Medicare for nearly 75% more anatomic pathology (AP) specimens compared to non self-referring physicians, according to a study published today in a leading health care policy journal. Furthermore, the study found no increase in cancer detection for the patients of self-referring physicians—in fact, the detection rate was 14% lower than that of non self-referring physicians.
These findings, from an independent study co-funded by the CAP, provide the first clear evidence that self-referral of anatomic pathology services leads to increased utilization, higher Medicare spending, and lower rates of cancer detection. The study, led by renowned Georgetown University health care economist Jean Mitchell, PhD, will appear in the April 2012 issue of Health Affairs and is now available on the journal’s website. (Please note: Access to the article is only available via links from the CAP website.)
“The findings are irrefutable,” said CAP President Stanley J. Robboy MD, FCAP. “The Mitchell study raises a red flag on self-referral, giving evidence that it tends to increase utilization and cost with little or no patient benefit.”
This analysis also supports the College’s long-standing position that self-referral of anatomic pathology services needs to end by removing anatomic pathology from the exception in the Stark Law.
“We need to close a loophole in the law to prevent anatomic pathology from being referred to labs where referring physicians have a financial self interest,” said Dr. Robboy.
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