Pay Now, Benefits May Follow — The Case of Cardiac Computed Tomographic Angiography

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Abstract
The average American might assume that new medical procedures are proved beneficial before insurers pay for them. In reality, many new procedures are paid for even with no persuasive evidence of benefit. One consequence is health care expenditures that are growing substantially faster than the economy and a Medicare program projected to become insolvent in the next decade. Increased use of technology is the largest driver of this growth; its effect dwarfs that of the aging of our population. We should be able to curb these costs and increase value in health care by taking an evidence-based approach to insurance coverage — but our political environment and medical culture undermine efforts to do so.

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