Providing professional mammography services: Financial analysis

PURPOSE: To perform a financial analysis of mammography services to determi ne whether the key underlying economic drivers of this service are aligned with the public's expectations. MATERIALS AND METHODS: The financial status of mammography services at seve n university-based programs was assessed by using an extensive financial su rvey encompassing revenue, direct and indirect costs, and volume data for 1 997 and 1998. At one of the institutions, an activity-based costing analysi s was performed by procedure type: screening mammography, diagnostic mammog raphy, breast ultrasonography, interventional procedures, and review of out side mammograms. RESULTS: All seven institutions incurred losses in the professional compone nt of mammography services. The underlying financial problem was a negative contribution margin (total mammography revenues minus direct expenses). Th e driver of the financial loss was the volume of diagnostic mammograms, whi ch generated a loss per procedure. Diagnostic mammogram volume drove the ma mmography full-time equivalent count (P = .039) and was highly and negative ly correlated with contribution margin (P < .001). CONCLUSION: The reimbursement rate for mammography procedures, especially d iagnostic mammography, needs to be increased to reflect the current reality of the resources necessary to maintain the accessibility and accuracy of t his evolving mix of clinical services.