Advanced imaging boomed during the 1990s and early 2000s—growing more than 6% per year—but a July Health Affairs study found that imaging's annual growth rate decelerated to 1% to 3% between 2006 and 2009.
Looking at Medicare, private insurer trends
For the study, GE Healthcare's David Lee and Massachusetts Institute of Technology's Frank Levy analyzed claims data from Medicare and three commercial insurers. They further combined supplemental data with interviews from radiologists, medical group administrators, as well as radiology benefits managers and recruiters in order to determine causes for the slowdown in growth.
According to Medicare data, the annual growth rate for:
- CT scans was 14.3% between 2000 and 2005, but fell to just 1.4% in 2009; and
- Magnetic resonance imaging (MRI) was 14% between 2000 and 2005, but fell to 2.6% between in 2006 and 2009.
Data from private insurers also showed similar patterns. For example, one of the studied insurers—which covers 1.1 million individuals under employer-sponsored plans—reported that the annual growth rate for:
- CT scans was 20.4% between 2002 and 2006, but dipped to only 3.1% between 2006 and 2009; and
- MRI was 16.6% between 2002 and 2006, but fell to 1.1% between in 2006 and 2009.
Researchers attributed the decline in growth to four factors:
1. Widespread implementation of prior authorization
2. Increased financial responsibility for patients
3. Reimbursement reductions
4. Changing public perceptions of radiation
Researchers found that the exams "that played a prominent role in the overall slowdown in the growth of imaging have been cited in the past as being potentially of lower medical value as well as sources of overuse," particularly exams of the spine, extremity joints, and pelvis.
According to the study, the slowing growth rate for imaging has weakened radiologists' job prospects, resulting in less demand (Evans, Modern Healthcare, 7/25; Lee/Levy, Health Affairs).
The Advisory Board's take
Stephanie Krent, Imaging Performance Partnership
While the news may not surprise any imaging leaders, this high-profile article raises awareness of the slowdown in imaging utilization, perhaps the first to do so since MedPAC’s report last year. Click here to see our take on what matters for radiologists and patients.
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