Medical Imaging Facts
Value of CT Utilization: A recent analysis of national trends in use of computed tomography in the emergency department concludes the increased use of CT in the ED has been associated with a decline in admissions or transfers after CT use, although this effect has stabilized more recently. Commenting on the results, Dr. Kocher noted “[CTs] provide lots of information quickly and so doctors and patients see CTs as a means of arriving at diagnoses efficiently and conveniently. Couple that with the fact that CT scanners are commonly housed in or near the ED itself, and the barriers to getting the test done are lower than in the past."
Keith E. Kocher, MD, MPHA, William J. Meurer, MD, MS, Reza Fazel, MD, MSc, Phillip A. Scott, MD, Harlan M. Krumholz, MD, SM, Brahmajee K. Nallamothu, MD, MPH, National Trends in Use of Computed Tomography in the Emergency Department, Annals of Emergency Medicine, August 12, 2011, (published online)
Multiple Examinations Create Modest Efficiencies: An expert panel analyzed the potential efficiencies when multiple examinations are performed on the same patient during the same session. By comparing the potential duplications in preservice and postservice work, the researchers calculated the maximum potential percentage work duplication for several diagnostic modalities. The percentage work reductions, which ranged from 4.32% for CT to 8.15% for ultrasound, would reduce Medicare payments by 2.96% and 5.45% for CT and ultrasound, respectively. The payment impacts are an order of magnitude less than the Government Accountability Office's recommendations.
Bibb Allen Jr, MD, William D. Donovan, MD, MPH, Geraldine McGinty, MD, MBA, Robert M. Barr, MD, Ezequiel Silva III, MD, Richard Duszak Jr, MD, Angela J. Kim, MS, Pam Kassing, MPA, RCC, Professional Component Payment Reductions for Diagnostic Imaging Examinations When More Than One Service Is Rendered by the Same Provider in the Same Session: An Analysis of Relevant Payment Policy, Journal of the American College of Radiology, Volume 8, Issue 9, September 2011, pages 610-616
Medicare Utilization Trends: Imaging growth in Medicare is less than 2 percent per year and advanced imaging growth is roughly half that of three years ago. These findings are from a review of claims by The Moran Company. Unlike most other Medicare services, spending on medical imaging is at roughly the same level as in 2004.
The Moran Company, Trends in Imaging Services Billed to Part B Medicare Carriers and Paid under the Medicare Physician Fee Schedule, 1999-2009: Executive Summary Prepared for the Access to Medical Imaging Coalition, October 2010
Medical Imaging and Life Expectancy: A National Bureau of Economic Research study showed that increased use of medical imaging is directly tied to an increase in life expectancy for Americans. And that those who had lesser access to imaging had a smaller increase in life expectancy. The study also indicated that states with larger increases in the quality of diagnostic procedures, drugs and physicians had larger increases in life expectancy, but did not have larger increases in per capita medical expenditure. Such deep and continued cuts may ultimately reverse these gains.
Frank R. Lichtenberg, The Quality of Medical Care, Behavioral Risk Factors, and Longevity Growth, NBER Working Paper No. 15068, June 2009
Medical Imaging Equipment Utilization: A Radiology Business Management Association (RBMA) survey of freestanding/outpatient imaging centers shows that the national average equipment utilization rate is only 54 percent. The results, which vary by a variety of characteristics, indicate that the present equipment utilization rate assumption of 75 percent is artificially high. For example, equipment utilization rates are significantly lower for rural centers. The authors suggest that the current assumption of equipment utilization used in Medicare payment is consistent with the actual utilization and RBMA cautions that any increase in the equipment utilization rate of the Medicare payment formula would result in multiple adverse impacts on imaging care.
