Imaging use in steady decline
Contradicting the common argument that an overuse of diagnostic imaging procedures is driving up healthcare costs, a new study from the Harvey L. Neiman Health Policy Institute shows physicians are actually ordering fewer imaging exams for Medicare patients.
The study, published Tuesday in the July issue of the Journal of the American College of Radiology, examines an array of evidence beyond what previous reports on imaging costs have looked at, researchers say.
Rather than just studying Medicare spending data, the Neiman Institute research uses federally-collected Medical Expenditure Panel Survey data, which allows an analysis of physician decisions and actions during patient visits.
Research shows that the number of physician visits by patients 65 years of age or older resulting in an imaging exam is consistently trending downward – from 12.8 percent in 2003 to 10.6 percent in 2011.
Similarly, the data shows that Medicare spending per enrollee for imaging has declined from $418 in 2006 to $390 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," said Danny Hughes, one of the authors of the imaging utilization study. "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."
Neiman Institute officials say the findings are significant because the Deficit Reduction Act of 2005 already markedly reduced financial payments for diagnostic imaging, and further threats to imaging reimbursements are on the horizon in the form of budget sequestration and potential changes to the Medicare Strategic Growth Rate formula.
"A failure to understand the changes in utilization that may accompany these potential payment reductions could ultimately produce adverse effects on patient care regardless of whether the intended cost containment goals are realized," researchers wrote in the report.
The Neiman Institute 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. Its research provides a foundation for evidence-based imaging policy to improve patient care and bolster efficient, effective use of health care resources.
"Further study is needed in this area," said Hughes. "We know from previous research that use of imaging leads to reduced rates of hospital readmissions, fewer unnecessary procedures, shorter hospital stays, longer lifespans and lower mortality rates. As we look at imaging utilization and spending, we need to understand the whole picture of imaging's relationship to health care cost trends and quality of care."