Provincial auditor criticizes MRI wait times, physician overbilling

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Provincial auditor finds private MRIs aren’t reducing wait times – Jun 8, 2017

MRI wait lists are growing, and the Regina Qu’Appelle Health Authority doesn’t know why, according to the provincial auditor.

“They don’t have enough information to enable them to figure out the reasons for the wait times,” provincial auditor Judy Ferguson said.

The two-for-one privatized MRI model was touted as the provincial government’s answer to long wait times. Ferguson said it hasn’t fixed the problem, although it is still early.

“The wait time at the end of March to the wait time at the end of December, it’s actually gone up. Slightly, but it’s gone up,” she said, adding that the privatized model had only been in place for nine months at the time of the audit.

“I think many of those programs take a bit of time to sort of settle in, to work out the kinks, and make sure they’re achieving the objectives that they had,” Keith Dewar, Regina Qu’Appelle Health Region’s president and CEO, said. “And I guess the other thing we don’t know is, what would the wait times be if we didn’t have that, or if we didn’t have some of the other improvements.”

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Ferguson also noted the current MRI process is taking a lot of resources because it’s too manually intensive.

“They’re literally sending lists back and forth, back and forth. There’s a delay in getting the information for people who have gotten the MRI through the one-for-one model, and so there’s a delay in the accuracy in the records because sometimes it’s not inputted until a month later,” she said.

The health authority also needs to do more to monitor the performance of the contracted MRI service providers, Ferguson said.

“Part of the arrangement there under the agreement is that the service providers are supposed to be assessing the quality of the radiologist and providing a report back to Regina Qu’appelle,” she said.

“Regina Qu’Appelle wasn’t getting that report yet.”

According to the auditor, another problem is physician billing. More than $500 million dollars is paid to doctors annually using an IT system that is 50 years old.

“There is a legitimate risk that the ministry is overpaying, so it needs to do more to stop that, and secondly, it needs to do more to investigate,” Ferguson said.

Ferguson’s audit found nearly 80 physicians made questionable billings. Ministry staff manually assessed some, reducing payments by $9 million last year. Saskatchewan’s Joint Medical Professional Review Committee can only investigate about nine cases a year.

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“The committee has proven itself to be a successful deterrent in that physicians are aware of it,” Gord Tweed, Medical Services Branch Acting executive director, said.

“The IT system that we use today, I would suggest is a reliable system, but it is dated, and as technology advances very quickly, there are things that we could build into a new system when that option became available to us,” Tweed said.

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