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Imaging Use Decline Contributing to Health Care Inflation Cut

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  • December 13, 2012
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CT scanLower Medicare reimbursements and fewer referrals for magnetic resonance imaging (MRI), computerized tomography (CT), and cardiac nuclear scans are contributing to the slower rise in health inflation, research indicates. A new study published in the Journal of the American College of Radiology shows a 21 percent plunge in spending—from $11.91 billion to $9.46 billion—on diagnostic imaging by Medicare Part B from 2006 to 2010.
The author of the study, Dr. David C. Levin, chairman emeritus of the radiology department at Thomas Jefferson University Hospitals in Philadelphia, said, “Doctors all around the country are being bombarded with material and literature saying, ‘We’ve got to cut down on the use of imaging. We’ve got to try to reduce the cost of care,’” Kaiser Health News reports.
While imaging makes up only 5 percent of overall health care costs, the relatively expensive services prompted Medicare to pay less and commercial payers to admonish providers to cut utilization.
Several years ago, the government began cutting what it paid for MRI scans, demanding discounts for multiple examinations in the same session, changing the formula for calculating physician expenses, and making other payment adjustments. Everybody knew reimbursements were down, Levin told Kaiser, “but I don’t think people were aware of the aggregate effect.”
What’s going on in Medicare is probably happening with private health insurers, too, he said. Most have hired “radiology benefit management” (RBM) companies to second-guess doctors who order expensive scans. Levin said he believes RBM firms may be the most important factor in reducing the growth in radiology procedures. Although Medicare isn’t using them, yet, knowledge that somebody is looking over their shoulders has probably prompted physicians to order fewer scans for all patients, he said.

Certified Interventional Radiology Cardiovascular Coder CIRCC

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