Medicare imaging costs down since 2006

Medicare imaging costs down since 2006

Overall noninvasive diagnostic imaging (NDI) costs to Medicare Part B dropped 21 percent from 2006 to 2010, according to a study in the September issue of the Journal of the American College of Radiology.

“This study confirms that medical imaging costs are down significantly in recent years and runs counter to misconceptions that imaging scans serve a primary role in rising medical costs,” said David C. Levin, MD, lead author of the study. “This study should provide lawmakers and regulators with more current information on which to base medical imaging policies and allow them to correctly focus on other areas of medicine that may be seeing cost increases.”

Medicare Part B databases for 2000 to 2010 were used for the study, in which all NDI codes were selected. Medicare physician specialty codes were used to identify radiologists, cardiologists, all other non-radiologist physicians as a group, and independent diagnostic testing facilities. Overall, Part B spending for NDI rose from $5.9 billion in 2000 to $11.9 billion in 2006, but declined to $9.5 billion in 2010. Similar trends occurred across the medical specialty settings and in independent diagnostic testing facilities.

“Medical imaging costs peaked in 2006, after doctors discovered that they could diagnose, treat or rule out serious conditions more safely and efficiently using scans rather than exploratory surgeries or admitting patients who did not need to be hospitalized. But in the subsequent years, reimbursement cuts have made a big dent in imaging costs,” Levin said. “Also, utilization tightened as providers became more educated about when and which scans to order and radiation education efforts proliferated. This study shows that imaging has matured as it serves an increasingly vital role in modern health care.”

According to a November 2010 Medical Dealer article, diagnostic imaging spending declined after the effective date of the Deficit Reduction Act of 2005, which included cuts to imaging reimbursement. Other developments at the federal level have negatively affected imaging reimbursement, according to the study authors, including multiple procedure payment reduction (MPPR) and The U.S. Centers for Medicare and Medicaid Services’ (CMS) 2010 decision to revalue imaging practice expense per hour, from $204 to $135.

These findings are in line with a recent Health Care Cost Institute report that imaging is the slowest growing of all physician services among privately insured individuals and that Medicare imaging use (overall) is down in recent years.