Medical Imaging Among Medicare Patients Continues to Decline

July 9, 2013

Medical imaging policy should not depend on spending alone, as evidenced by a decrease in imaging tests performed, while costs stay steady or rise.

Medical imaging rates significantly and consistently continue to decline among Medicare patients nationwide, according to a study published in the Journal of the American College of Radiology.

In an effort to control medical and healthcare costs, medical imaging is often targeted as a major cost factor, resulting in actions such as markedly lower payments for imaging as per the Deficit Reduction Act (DRA) from 2005. However, researchers from the ACR’s Harvey L. Neiman Health Policy Institute found that there has actually been a downward trend in imaging exams among the Medicare population since 2003 - two years before the DRA mandate. This finding is important because further payment cuts are threatened.

In this study, the researchers sought to investigate trends in utilization and spending for medical imaging, using medical visits that resulted in imaging as their metric. They examined Medicare Part B claims data from 2003 to 2011 to measure per-enrollee spending, as well as household component events data on the elderly Medicare-age population. This data was obtained from the Medical Expenditure Panel Survey from 2003 to 2010, which allowed for an analysis of physician decisions and actions during the patient visits.

The results showed that the annual health spending and Medicare payments for imaging rose in this population from $294 per enrollee in 2003 to $418 in 2006 and then payments declined to $390 by 2011. They also found that at the same time, annual medical visits by similar Medicare-age patients that resulted in an imaging test dropped from 12.8 percent in 2003 to 10.6 percent in 2011.

“This study should prompt a rethinking of the assumption that diagnostic imaging is a leading contributor to the nation’s health spending challenges,” co-author Danny Hughes, PhD, said in a release. “When you look at the available evidence in a truly patient-centered way, understanding what occurs on a patient visit to the doctor, then you see that physicians are calling for less, not more, imaging tests.”

Further study is needed, noted the authors. Use of imaging can result in shorter hospital stays, reduced readmission rates, and fewer unnecessary procedures, as well as longer life spans and lower mortality rates. But, Hughes said, “We need to understand the whole picture of imaging’s relationship of health care cost trends and quality of care.”