Screening Mammography: Quality Standards Are Needed in A Developing Market

GAO discussed the quality of screening mammography. GAO noted that: (1) many of the 1,485 mammography providers surveyed in 4 states lacked adequate quality assurance programs; (2) although providers that reported the highest quality standard compliance rates performed the highest volume of mammography, there was no consistent relationship between what providers charged for screening mammograms and their compliance with quality standards; (3) providing screening in regulated, high-volume settings could help ensure the availability of safe and accurate screening mammography at a cost consistent with the Medicare fee limit; (4) federal and state oversight of mammography services is limited because no laws exist requiring providers to maintain adequate quality standards; (5) primary care physicians and multi-specialty clinics consistently reported the lowest quality assurance standard compliance rates; (6) state inspections indicated problems in image quality and dose that underscore the need for federal quality standards; (7) the Health Care Financing Administration's (HCFA) 1991 regulations for Medicare-funded screening mammography parallelled professional quality standards designed to ensure safe and reliable screening services; (8) women who lacked Medicare coverage and were recommended for regular screening mammography often obtained services at facilities that did not meet HCFA quality standards; and (9) it believes that Congress may wish to consider options to encourage states to regulate screening mammography more stringently.