Medicare Spending For Medical Imaging Sustained Dramatic Slowdown Compared With Other Services

Slowing Volume Growth and Massive Medicare Payment Cuts Put Diagnostic Imaging Near Bottom of Services Contributing to Growth in Medicare Spending, New Study Finds

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 Harvey L. Neiman Health Policy Institute Chief Medical Officer Richard Duszak, Jr., MD, FACR, one of the co-authors 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 5 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 CT and 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 at the Neiman Health Policy Institute, who co-authored 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 policy makers 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.

About The Harvey L. Neiman Health Policy Institute
The Harvey L. Neiman Health Policy Institute is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety, and efficiency of health care.