Policy, Reimbursement Changes Linked to Slowing Growth in Radiology Imaging Studies

August 1, 2012 | Strategic Insights for Health System


A sharp reduction in the growth of medical imaging, including magnetic resonance imaging (MRI), computed tomography (CT), and  positron emission tomography (PET), for Medicare beneficiaries occurred in 2006 and 2007, ending a decade of growth that had exceeded 6 percent annually, according to a study published in the July 2012 issue of Health Affairs. To determine what factors caused the slowdown, whether it was good or bad for patients, and whether the slowdown persisted and extend to non-Medicare-insured patients, researchers interviewed healthcare professionals and examined insurers’ claims file data. Their preliminary analysis concluded that the slowdown in the growth in use of imaging persisted to 2009 and extended to the non-Medicare, commercially insured population. Prior authorization policies in place for half of commercially insured patients, higher deductibles, and lower reimbursements offset strong nonmedical incentives, such as physicians’ fear of malpractice litigation or a desire to generate revenue to order imaging studies.

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