The Senior Center for Health & Security

The Value of Diagnostic Testing in Health Care

Diagnostics, or clinical lab tests, play an important role in ensuring patients receive quality health care and controlling long-term health care costs. While diagnostics comprise only about 5% of hospital costs and approximately 1.6% of all Medicare costs, their results directly influence as much as 70% of all health care and treatment decisions.

Advances in lab testing allow for faster and more accurate diagnosing and can lead to less invasive and more effective treatment. Today's tests allow doctors to tailor treatments to patients and more accurately monitor the progression of diseases.

A recent study on the valuable role diagnostic testing plays in health care delivery conducted by The Lewin Group documents the various way diagnostics influence patient care. It shows that the value of diagnostics goes well beyond simply diagnosing disease. Some important roles of today's diagnostic testing include:

• Assessing a patients risk of disease sooner
• Making a faster, more accurate diagnosis - often before symptoms appear
• Selecting more targeted and less invasive treatments
• Managing chronic disease effectively

The report also found that many of prescribed tests were being under utilized. This can have significant implications on the long-term cost of an individual's health care.

For example:

Cardiovascular disease remains the leading cause of death in America, killing 700,000 people annually. Congestive heart failure alone accounts for as much as three percent of all US health care expenditures. Like most diseases, early intervention is predictive of long-term survival, so it's important to get care at the first sign of a problem.

Yet, many people who enter the emergency department with chest pain or shortness of breath may be admitted to the hospital unnecessarily, costing the health care system more than $12 billion each year. Even worse, an estimated one of every 10 patients who truly are experiencing a heart attack or congestive heart failure are mistakenly sent home without treatment, increasing their risk of sudden death or heart damage and setting the hospital up for a potentially expensive lawsuit.

But today, two relatively new diagnostic tests are improving a physician's ability to correctly diagnose a heart attack or heart failure, saving lives, time and money.

Medicare and Diagnostic Testing

Medicare has always covered some diagnostic tests like CT Scans, MRIs, EKGs, and X-rays. The Medicare Modernization Act introduced many new preventative screenings to Medicare that were previous unavailable to seniors. Medicare now covers:

• Cardiovascular screenings that check cholesterol and lipid levels
• Screening for Diabetes
• Bone mass measurements aimed at preventing osteoporosis
• Screenings for breast, cervical, and prostate cancer

Only you and your doctor can determine what tests are right for you. The risks of diagnostic tests are generally small however, consult your health care professional about the risks for the specific diagnostic tests you have done.