Nation’s largest insurer wants 55% of radiology services delivered at freestanding sites by 2030

The nation’s largest commercial health insurer wants its members to receive at least 55% of their radiology services at freestanding imaging centers by 2030.

UnitedHealth Group announced the commitment on Tuesday, June 15, as part of its 2020 Sustainability Report, aimed at expanding access, reducing costs and bolstering outcomes. The Minnetonka, Minnesota-based health giant also wants 55% of outpatient surgeries delivered outside of hospitals by the end of the 2020s.

“Medical care provided at sites of care that meet quality and cost-efficiency criteria predictably leads to better health outcomes at a lower cost for the consumer,” UnitedHealth said in its 64-page report. “In particular, ambulatory surgery centers and stand-alone imaging centers frequently provide the same or better quality care at a lower cost compared to a hospital.”

UnitedHealth estimated that the average price for a routine diagnostic imaging at a hospital outpatient department can cost 165% more than the price of a test performed at a physician’s office or stand-alone center. The company has already made some inroads on this front, with 47% of radiology services and outpatient surgeries among its members delivered at freestanding sites as of 2019.

The insurer said it has made these gains by equipping referring physicians with shared decision-making tools to help patients select the best site for imaging services. UnitedHealth is also offering other digital tools to help beneficiaries “identify the care setting that best suits their medical and financial needs.” Shifting routine diagnostic imaging from outpatient hospital departments to stand-alone centers or doc offices could reduce U.S. healthcare spending by 62% and save consumers $300 per exam, the report claimed.

This is just the latest in a series of maneuvers by UnitedHealthcare and its parent UnitedHealth Group to reduce radiologist pay. Other actions include cutting health systems and doc groups out of its network, steering patients toward certain tests, and adding new prior authorization processes.

UnitedHealth’s plans cover some 70 million members, with policies offered in all 50 states. In 2019, the company recorded $13.8 billion in profits on revenue of $257.1 billion.

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