Diagnostic Imaging Rates Plummet

A sharp drop in the growth of diagnostic imaging appears to have been caused by approval rules put in place in recent years, according to a study published online in the journal Health Affairs. Lead author David W. Lee, the head of health economics and reimbursement for the United States and Canada at GE Healthcare in Waukesha, Wisconsin, and colleagues wrote that the growth in the use of advanced imaging for Medicare beneficiaries "decelerated in 2006 and 2007, ending a decade of growth that had exceeded 6 percent annually."    The authors say that the slowdown raises three questions: 1. Did the slowdown in growth of imaging under Medicare persist and extend to the non-Medicare insured? 2. What factors caused the slowdown? 3. Was the slowdown good or bad for patients?    They used claims file data and interviews with health care professionals and found that the growth of imaging use among both Medicare beneficiaries and the non-Medicare insured slowed to 1–3 percent per year through 2009. One by-product of this deceleration in imaging growth "was a weaker market for radiologists, who until recently could demand top salaries." They also noted that "a meaningful fraction of the reduction in use involved imaging studies previously identified as having unproven medical value  and concluded that what has occurred in the imaging field suggests incentive-based cost control measures can be a "useful complement to comparative effectiveness research when a procedure’s ultimate clinical benefit is uncertain."    In response, the American College of Radiology released a statement entitled "Medical Imaging Study in Health Affairs Incomplete and Potentially Misleading." The release pointed out, for example, that a study published in Health Affairs in December of 2011 reported that as many as 12,000 American seniors "may have suffered broken bones due to Medicare cuts in reimbursement for just one type of imaging scan (dual energy X-ray absorptiometry – 'DEXA'). This is only one example of detrimental effects of more than $5 billion in Medicare imaging cuts since 2005 . . .The cuts and closures are forcing seniors to commute further and wait longer to receive care and may force seniors to pay more out of pocket in co-pays as imaging access retreats to the larger hospital setting where care is more expensive."