Original articleTrends in the Utilization of Outpatient Advanced Imaging After the Deficit Reduction Act
Section snippets
Methods
We used the Medicare Physician/Supplier Procedure Summary Master Files for 2000 through 2009. These files cover all beneficiaries in the traditional Medicare fee-for-service program (34,938,000 in 2009) but not those in Medicare Advantage plans. For each code in the Current Procedural Terminology®, fourth ed, the files show procedure volume and other administrative data. We aggregated all codes for CT and CT angiography, MRI and MR angiography, and nuclear medicine (including PET) and tracked
Results
Table 1 shows both private office and HOPD Medicare volumes for each of the 3 modalities in 2000, 2006, and 2009. Compound annual growth rates (yearly growth) are shown for 2000 to 2006 and 2007 to 2009. Fig 1, Fig 2, Fig 3 show the growth trends for, respectively, CT, MRI, and nuclear medicine (including PET).
As noted in Table 1, rapid outpatient growth occurred in all 3 modalities from 2000 through 2006, more so in offices than in HOPDs. Yearly growth in all 3 modalities in both the office
Discussion
As noted earlier, the DRA cuts posed 3 related questions or concerns from a health policy perspective: (1) Would private office imaging facilities be forced to close? (2) Would advanced imaging examinations therefore have to be shifted to less convenient HOPDs? and (3) Would patient access to advanced imaging examinations be jeopardized?
There are no precise data available anywhere on how many imaging office facilities may have closed since the DRA took effect. Although some have undoubtedly
Conclusions
We have examined recent trends in Medicare utilization of outpatient advanced imaging. There have been important developments. The rapid growth in outpatient CT and MRI that characterized the years before 2005 has largely abated. In nuclear medicine, there has actually been a substantial decline, despite rapid growth in PET. These changes do not seem to have been caused by the DRA, as there has not been a large shift of volume from offices to HOPDs. Although access for Medicare beneficiaries to
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Cited by (0)
This study was funded in part by a grant from the American College of Radiology (Reston, Va).