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Vendor praises imaging contract savings but warns district is missing preventive screenings
Summary
Express Medical Group told the board its imaging contract reduces adjusted imaging costs versus gross charges, but outpatient exam volume has fallen and higher-use MRIs and low preventive-screening rates (mammograms, echoes, chest X-rays, lung CTs) could raise long-term costs unless member/provider outreach increases.
George Castrullis, CEO of Express Medical Group, presented the district's imaging data and contract terms and said the vendor's contracted payment would be lower than the district's prior adjusted payments. Castrullis said gross outpatient imaging charges averaged about $30,140 per month with an adjusted Blue Cross Blue Shield payment near $21,000, while the vendor's contract figure is $13,500 per month.
Castrullis described an unexpected utilization pattern: overall outpatient exam counts dropped from about 129 to 79 per month after the vendor began work, yet MRI volume rose roughly 35%. "We're actually seeing a decrease in total utilization per month. MRIs have increased by 35%," he said, adding that the increase is concentrated in spine and extremity MRIs—episodic, higher-cost imaging—rather than preventive modalities that can avert acute hospital care.
He flagged several preventive imaging categories that are underused in the plan's experience: mammograms, chest X-rays, echocardiograms, CT lung screening and vascular scans such as abdominal aortic aneurysm (AAA) and carotid screening. Castrullis argued that the current pattern looks like episodic urgent-care use rather than a proactive preventive program and recommended both provider and member education initiatives to shift utilization toward preventive screening that can reduce downstream hospitalization costs.
As concrete outreach ideas, Castrullis proposed targeted monthly educational content (for example, a podcast or pre-planning presentations), screening rollouts for conditions with clear screening protocols, and working with school administrators to share information. The board discussed incentives and communication strategies to raise awareness of no-cost preventive services available through the wellness center.
Staff and the vendor agreed to continue analyzing utilization and education strategies; the Marathon presentation was deferred to allow another month of data. No contractual modifications were approved at the workshop.
