{"database": "press", "table": "releases", "rows": [["https://paulsen.house.gov/index.cfm?sectionid=105&itemid=1400", "Star Tribune: A medical-testing lesson from Minnesota: Less can be more", "2014-01-06", "2014", "2014-01", "Republican", "House", "MN", "Erik Paulsen", "P000594", "paulsen.house.gov", null, null, "legacy", "A novel strategy that has saved Minnesota millions of dollars in unnecessary medical-imaging scans \u2014 and probably prevented dozens of patient deaths \u2014 might soon go national.\r\n\t\t\t\r\n\t\t\t\tLeaders from Minnesota\u2019s medical and insurance communities met Monday morning to celebrate the project \u2014 which has leveled off the skyrocketing growth of MRI and CT scans for back pain, headaches and other problems \u2014 and to promote legislation by Rep. Erik Paulsen that would bring it to bear on the federal government\u2019s vast Medicare program.\r\n\t\t\t\r\n\t\t\t\tMinnesota\u2019s \u201cdecision support\u201d strategy, enacted in 2006, created a single set of standards for doctors to follow in deciding when patients need the costly scans. It also created a green-yellow-red coding system to show patients when scans were recommended and when they weren\u2019t. The use of such scans, which had been growing at a 7 percent annual clip, grew just 1 percent from 2007 to 2012.\r\n\t\t\t\r\n\t\t\t\t\u201cIt happened immediately,\u201d said Cally Vinz, a vice president of health care improvement for the Institute for Clinical Systems Improvement, or ICSI.\r\n\t\t\t\r\n\t\t\t\tThe Bloomington-based collaborative advises Minnesota health plans, physicians and other providers on ideal medical policies and practices. One recent ICSI project aimed at improving efficiencies was the so-called DIAMOND program to assist primary care clinics in treating patients with depression.\r\n\t\t\t\r\n\t\t\t\tICSI estimates that the medical-imaging protocol has prevented $234 million in questionable or unnecessary scans, and 96 cancer-related deaths that would have been expected due to the radiation exposure that comes with CT scans, had use of the scans continued growing at previous rates.\r\n\t\t\t\r\n\t\t\t\tAnd although patients sometimes want more and better medical tests, ICSI officials said patients are often glad to receive the \u201cgood news\u201d that they don\u2019t need an imaging scan based on their condition, or that they should wait to see if other symptoms emerge first. Vinz recalled one woman whose doctor showed her that a proposed scan in her case would be in the \u201cred\u201d category, suggesting it wouldn\u2019t be worth the risk and the cost.\r\n\t\t\t\r\n\t\t\t\t\u201cWell, I don\u2019t want a red!\u201d the woman exclaimed.\r\n\t\t\t\r\n\t\t\t\tPaulsen, a Republican who represents Minnesota\u2019s Third Congressional District and has authored several health-reform measures, said he hopes the evidence, combined with a favorable political climate in Congress, make the timing right for the Minnesota approach to be replicated in Medicare, the government health care program for the elderly and disabled. Medicare\u2019s outlays have grown rapidly in the past two decades, reaching nearly $600 billion last year, making it a regular target in Congressional budget discussions.\r\n\t\t\t\r\n\t\t\t\tLawmakers are trying to reform the so-called sustainable growth rate formula, which determines how much Medicare pays physicians for services, and Paulsen said he believes his bill could become part of that effort.\r\n\t\t\t\r\n\t\t\t\t\u201cIf you let this slip away,\u201d he told the group Monday, \u201cit\u2019s going to be a lot more difficult to solve later.\u201d\r\n\t\t\t\r\n\t\t\t\tVinz said she has talked with insurance and health care leaders in other states about this approach, in part because alternatives such as prior notification \u2014 which requires insurers to sign off on scans before they are performed \u2014 create adversarial relationships between patients, doctors and insurers. Minnesota health plans had adopted prior-notice rules in 2006, but phased them out due to the success with the decision-support tool.\r\n\t\t\t\r\n\t\t\t\tBut officials in other states often view Minnesota as \u201cquite peculiar\u201d because of its small, cooperative community of insurers and physician groups, and don\u2019t believe its innovations can be repeated elsewhere, said Dr. Pat Courneya, medical director of HealthPartners, the Bloomington-based health plan.\r\n\t\t\t\r\n\t\t\t\tGetting this type of approach to succeed in Medicare, on the other hand, would cause it to spread to other states, he said.\r\n\t\t\t\r\n\t\t\t\tMore than 80 percent of imaging scans in Minnesota are now ordered only after doctors seek out decision-support guidance to make sure they are recommended based on their patients\u2019 conditions and medical histories.\r\n\t\t\t\r\n\t\t\t\tCourneya said the initial guidelines were based on the clinical expertise and recommendations of Minnesota doctors. They have since been revised as studies refine when imaging scans should be used. Research, for example, has identified the types of patients who are suitable for scans to screen for breast or lung cancers.\r\n\t\t\t\r\n\t\t\t\tCourneya said he hopes the \u201cdecision support\u201d tool can grow to include genetic testing and other medical tests that doctors and patients don\u2019t know for certain when to use.\r\n\t\t\t\r\n\t\t\t\tRead the entire piece online here.", 1, "2026-03-30T12:14:52Z", "2026-03-30T12:14:52Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["https://paulsen.house.gov/index.cfm?sectionid=105&itemid=1400"], "units": {}, "query_ms": 1.5114429406821728, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}