The Economic Impact of Screening Mammogram Image Quality-Related Retakes and Recalls: A Modeling Study from the Provider Perspective

OBJECTIVES: Poor image quality resulting from positioning challenges or patient movement is a common issue that can necessitate screening mammogram retakes during the initial exam (same-day retake) or require a patient to return on a different day for additional imaging (technical recall). The aim of this study was to estimate the economic impact and efficiency implications of screening mammogram same-day retakes and technical recalls due to poor image quality from the facility perspective.

METHODS: We constructed an Excel-based model. Facility characteristics were estimated from market research and published literature. Approximations of the rate of and time required for same-day retakes and technical recalls and other image quality improvement activities were derived from internal market research data. CMS data was used to inform screening mammography reimbursement. The number, time, and opportunity cost of same-day retakes and technical recalls were calculated. Analyses were performed to assess the impact of same-day retake and technical recall rate reductions. A sensitivity analysis evaluated different baseline rates and times associated with same-day retakes and technical recalls.

RESULTS: Under the base case scenario of 5,000 screening mammograms per year, a 6% same-day retake rate, and a 3% technical recall rate, the number of same-day retakes and technical recalls per year was 450, amounting to 176.5 additional hours and an opportunity cost of $129,904. Under scenarios of 15-25% reductions in same-day retake and technical recall rates, the number of same-day retakes and technical recalls avoided per year ranged from 68-113, translating to 26.5-44.1 hours in time savings and $19,486-$32,476 in cost savings.

CONCLUSIONS: The economic impact of screening mammogram same-day retakes and technical recalls is non-negligible. Improvements in ease of positioning and image quality on mammography systems may reduce the rates of same-day retakes and technical recalls, resulting in efficiency gains and cost savings for facilities.