MANAGED CARE June 2008. ©MediMedia USA
Rates of use for three advanced imaging modalities — magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) scans — increased rapidly between 2000 and 2004.
Jean M. Mitchell, PhD, professor of public policy at Georgetown University, examined claims data for physician and outpatient services for people with health insurance coverage from a large private insurer in California. Mitchell was able to calculate relative changes in use rates by provider type (self-referral physicians, radiologists, hospitals, and independent diagnostic testing facilities). Findings were published in Medical Care.
The increases were most dramatic for PET, where the overall statewide utilization rate increased by almost 400 percent. MRI and CT rates also rose more than 50 percent.
“Health care costs are increasing by double digits and imaging is one of the major drivers of this,” says Mitchell. The other driver is physician self-referral, according to the study. In contrast, relative changes in the use of advanced imaging performed at hospitals were small.
Mitchell points to the average physician net income, which declined by 7 percent from 1995 to 2003 after adjusting for inflation.
“The cutback in payment of the Medicare fee schedule for surgical procedures and the volatile stock market during this time period” are factors for the increase in imaging scans says Mitchell.