How Much Do Common Imaging Studies Cost? A Nationwide Survey of Radiology Trainees

The objective of this study was to gauge the knowledge of radiology trainees regarding the costs of common imaging services and to assess their perceptions of current relevant education. During mid-2014, an online survey of 5325 U.S. residents and fellows who were members of the American College of Radiology was conducted. Respondents were asked to provide information about year of training, relevant advanced degrees (e.g., Master of Business Administration or Master of Public Health), number of hours of formal education in health care economics provided annually by their training program, self-perception of knowledge of health care economics, and desire to learn more about the costs of imaging. Respondents were asked to estimate Medicare-allowable fees for five commonly performed imaging examinations: two-view chest radiography, contrast-enhanced CT of the abdomen and pelvis, unenhanced MRI of the lumbar spine, complete abdominal ultrasound, and unenhanced CT of the brain. Responses within ± 25% of published allowable amounts in the Medicare fee schedule were deemed correct. A total of 1066 of 5325 trainees (20.0%) returned surveys that were sufficiently complete for analysis. Only 17.1% of all responses were correct; 65.3% of responses were overestimations of actual costs, and 17.6% were underestimations. Almost half of the trainees (45.1%) incorrectly estimated the cost of every examination. Overall, knowledge of costs of examinations did not improve with advancing years of training, hours of education in health care economics, or attainment of a relevant advanced degree. Only 9.3% of trainees considered their knowledge of imaging costs to be adequate. An overwhelming 89.7% of trainees desired more focused education. Radiology trainees have limited knowledge of the costs of commonly performed imaging studies. Effective training program curricula currently appear to be lacking. Targeted education and integration of cost information into clinical decision support tools are probably warranted.