Would you pay an additional fee to get your screening
mammography results right after your examination? In a random survey of 120
women, the majority said no. In fact, one-third of the women said they preferred
to get their results at a later time. The survey results were published in the
September 2001 issue of the American Journal of Roentgenology.
"We conducted the study to determine whether patients really wanted to
get their screening mammography results immediately, what the cost would be to
our facility to provide immediate reporting, and if patients would be
willing to pay at least part of those costs," said Sughra Raza, MD, the
lead author of the investigation.
"We were surprised that only 67% of the women indicated they preferred
immediate reporting," said Dr. Raza. "We expected this number to be
much higher because we are hearing from our patients and our referring
physicians that they want to know the results right away." A benefit to
immediate reporting is that if something is found on a screening mammogram,
additional tests can be performed immediately. In addition, the patient does not
have to wait to get her results, so she may feel less anxious about the
examination. "Despite what we’re hearing and the added convenience, there
was still a substantial number of women who are willing to wait for their
results," said Dr. Raza.
Effects of Cost and Reimbursement
Immediate reporting can cost a facility between $4 and $29. "We found
that if a facility is working at capacity and would need to add staff time,
equipment, and a room to allow the physician to talk to the patient about the
mammogram results, the cost for immediate reporting would be $28.22 per
patient," said Dr. Raza. On the other hand, if no additional space or
equipment was needed then the cost would be $4.38 per patient. These figures are
based on costs at Beth Israel Deaconess Medical Center in Boston, where the
study was conducted. "Costs will vary from place to place," said Dr.
Raza, who is now associate director of breast imaging at Brigham and Women’s
Hospital in Boston.
"Our survey found that the majority of our respondents don’t want to
help bear these costs," she said. Among patients who said they preferred
immediate reporting, 60% said they would not be willing to pay an additional
fee; 24% said they would pay an additional $10, and 11% said they would pay an
The cost factor is only one of the difficulties of immediate reporting, noted
Dr. Raza. Reimbursement is another problem. For example, while some insurance
policies will reimburse a sonogram performed on the same day as the screening
mammogram, many policies will not pay for the sonogram if an ultrasound-guided
procedure is also performed. In the latter case, only the procedure is
reimbursed. This means that if something is found on the mammogram, an
ultrasound can be performed but may not be fully paid for by insurance or,
alternatively, the patient has to come back for the ultrasound in order for
insurance to pay for it. In addition to these two issues, "immediate
reporting puts pressure on the radiologist to read mammograms rapidly and
accurately, with repeated interruptions," said Dr. Raza.