December 6, 2013 — Over the past decade, medical imaging has gone from being one of the fastest growing categories of Medicare spending to one of the slowest relative to other Medicare services, according to a new study.
“A number of studies have demonstrated that Medicare spending growth for medical imaging has slowed, but none have compared it with spending growth for other Medicare services,” said Richard Duszak Jr., M.D. FACR, chief medical officer, Harvey L. Neiman Health Policy Institute, and co-author of the study. “Our findings demonstrate that Medicare spending on medical imaging is not only in decline, but it is now one of the fastest declining Medicare service categories.”
The new study, published in the December issue of the American Journal of Roentgenology (AJR), sought to develop a comparative understanding of Medicare spending growth for medical imaging vis-à-vis other services. By analyzing Medicare claims data, researchers found that though medical imaging (and especially advanced medical imaging) was, at a time, one of the fastest growing categories of Medicare spending, that position has essentially reversed in the past five years. The findings indicate that while spending growth on diagnostic imaging was in the 80th percentile of all medical services in 2001, it had slowed to the point that it was only in the second growth percentile by 2011. These results hold for imaging as a whole, as well as advanced (such as computed tomography [CT] and magnetic resonance imaging [MRI]) and standard (such as X-ray and ultrasound) imaging services.
“It is important to shed light on such relative changes in spending, because policy makers who are interested in bending the cost curve typically focus their attention on services that are growing most rapidly and not necessarily just those with the largest absolute spending,” said Danny Hughes, Ph.D., senior researcher, Neiman Health Policy Institute, and co-author of the study. “This research provides those policy makers with an important piece of the puzzle, one that will be fundamental to understanding the bigger picture of Medicare spending moving forward.”
Researchers suggest that the explanation for the dramatic reversal in spending growth is likely multifactorial. Because spending is affected by both the unit price and volume of service, they attribute the change to the repeated and widespread unit payment reductions to medical imaging over the past several years, as well as the declining volume.
“It is no secret that many policymakers consider health care spending to be on an economically unsustainable trajectory,” said Duszak. “With an aging population and Medicare spending expected to double from 2011 to 2021, it is vital that we understand what service areas are growing most quickly, so we can better pinpoint what is contributing to the overall increase in Medicare spending.”
The Harvey L. Neiman Health Policy Institute (HPI) studies the value and role of radiology in evolving health care delivery and payment systems, including quality-based approaches to care and the impact of medical imaging on overall health care costs. HPI research provides a foundation for evidence-based imaging policy to improve patient care and bolster efficient, effective use of health care resources.