Medical Imaging: A Key Part of the Business Case for Quality
In 1997, the average cost for early stage cancer treatment was $11,000. But the average cost for cancer treatment at later stages hovered around $140,000. That is one of the reasons that businesses are beginning to measure the performance of providers and health plans in breast cancer screening for employees. In essence, mammography has become such a defining element of high quality care that businesses are using it to differentiate the performance of providers and health plans.
- The National Committee for Quality Assurance (NCQA) – which is the accreditation body for the nation's managed care plans – measures the percentage of women in the health plans who receive mammograms. Because clinical studies show that mammograms save lives through early detection, and save money through early treatment, NCQA stresses that plans with higher mammography screening rates offer better value for employers.
- In explaining why it measures performance of its health plans in breast cancer screening, the NCQA said, "Women who have their breast cancer detected early have more treatment choices and better chance for survival. Mammograms are the most effective method for detecting breast cancer at the time it is most treatable."1
- The Pacific Business Group on Health – a coalition of major California employers – is undertaking a plan to base part of the payment for providers and health plans on how well they perform on key quality measures. One of the primary measures, once again, is breast cancer screening. The group ran a pilot project in 2003 to let provider organizations and managed care plans become familiar with collecting data on performance on breast cancer screening, as well as other measures including childhood vaccinations, cervical cancer screening, and appropriate asthma medications. 2
1 "The State of Managed Care Quality, 2001," National Committee for Quality Assurance, Washington, DC
2 "P4P Clinical Measure Pilot, Final Report," California Cooperative Healthcare Reporting Initiative, September 5, 2003, Pacific Business Group on Health.
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