To quote James Carville, “it’s the economy, stupid.” And when it is done correctly, imaging screening can be a financial powerhouse that balances upfront costs against the massive societal and systemic expenses of late-stage disease.
RadROI: As Lyndon Luk, MD, broke it all down during the ARRS Online Course “Early Detection and Screening with Abdominal Imaging,” health economists use the incremental cost-effectiveness ratio (ICER)—primarily measured in Quality-Adjusted Life Years (QALY), where 1 QALY represents 1 year of perfect health.
- $100,000 = the standard threshold per QALY to determine if a treatment is cost-effective.
- $16,854 = the remarkably low cost per QALY for abdominal aortic aneurysm screening, making it a “pretty good deal” Dr. Luk said.
Down$tream: Sure, a screening ultrasound may have low reimbursement (or even operate at a loss), but it does serve as a gateway for revenue further down the pike. And identifying a chronic process or cancer triggers a cascade of high-cost diagnostic, procedural, and therapeutic services.
- VA Example: Over a decade, screening 20,000 veterans cost $2.8 million (143 per ultrasound). However, the resulting repairs and follow-up for the 1% who met criteria generated nearly $10 million in revenue.
- Failure Costs: An emergency repair for a ruptured aneurysm can exceed $124,000, compared to $43,000 for a planned endovascular repair.
We Live in a Society! Managing untreated chronic conditions and advanced cancers carries a staggering economic toll.
- In 2015, cancer deaths caused $94 billion in lost earnings in the U.S. alone—a figure estimated to be significantly higher in 2026.
- 3 of the top 5 cancers responsible for lost productivity are abdominopelvic, directly within rads’ purview.
RadFYI: As radiology inches ever closer toward opportunistic screening, radiologists can position themselves as central figures in creating a healthier society by instituting early treatment strategies that improve survival writ large.
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