Unjustified repeat tests common among Medicare patients

Dartmouth researchers found that up to half of older adults who had a heart, lung, stomach or bladder test had the same procedure repeated within three years despite guidelines against routine testing, leading to unnecessary costs.

Reuters: Repeat Testing Common Among Medicare Patients
In a new study, up to half - or more - of older adults on Medicare who had a heart, lung, stomach or bladder test had the same procedure repeated within three years. Those tests typically aren't supposed to be routinely repeated, researchers said. For some of them, such as echocardiography and stress tests for heart function, there are recommendations specifically against routine testing (Pittman, 11/19).

Modern Healthcare: Repeat Testing Common With Medicare Patients: Study
The study [in the Archives of Internal Medicine], which was led by Dr. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Research, analyzed testing patterns for a random sample of 5% of Medicare patients, and also looked at the proportion of repeated tests in the 50 largest metropolitan areas (Kutscher, 11/19). 

Medpage Today: Repeat Testing Common In Older Patients
[T]he rate of repeat testing varied widely from place to place, suggesting doctors in some regions are more likely to order repeat exams ... The finding has "important implications not only for the capacity to serve new patients and the ability to contain costs but also for the health of the population," they argued. Although the risks of the tests themselves are not great, they could substantially increase rates of incidental detection and overdiagnosis, Welch and colleagues concluded (Smith, 11/19).

Medscape: Medicare Patients Often Receive Unjustified Repeat Tests
In an accompanying commentary, Jerome P. Kassirer, MD, from Tufts University School of Medicine, Boston, Massachusetts, and Arnold Milstein, MD, MPH, from Stanford University School of Medicine, Palo Alto, California, write: "After decades of attention to unsustainable growth in health spending and its degradation of worker wages, employer economic vitality, state educational funding, and fiscal integrity, it is discouraging to contemplate the fresh evidence by Welch et al of our failure to curb waste of health care resources"  (Kelly, 11/19).

In other Medicare news --

Bloomberg:  Hospital Medicare Cash Lures Doctors As Costs Increase
Thomas Lewandowski, a Wisconsin heart doctor, was faced with a dilemma after his Medicare payments were cut and his overhead costs soared: Fire half his staff to keep his practice open, or sell it to a local hospital. He decided to sell, becoming one of more than 6,000 employees at Thedacare, which runs five hospitals and numerous clinics in northeast Wisconsin. It's a decision being made increasingly in the U.S., creating a new dynamic that threatens to raise the price of health care (Pettypiece, 11/19).