GAO: Unclear if accreditation requirements led to med imaging decline

The effect that the implementation of the 2012 Medicare accreditation requirement for suppliers of CT, MRI and nuclear medicine services has had on the decline in imaging growth is unclear, according to a report issued by the Government Accountability Office.

GAO found that the number of advanced diagnostic imaging services provided to Medicare beneficiaries in an office setting actually began to decline--and continued to decline--before the accreditation requirement went into effect on Jan. 1, 2012.

Moreover, GAO found the rate of decline from 2009 to 2010 was similar to the rate of decline from 2011 to 2012 for MRI, CT and nuclear medicine services. "These results suggest that the overall decline was driven, at least in part, by factors other than accreditation," the reports authors said.

The report further stated that the impact of the accreditation requirement is unclear in the context of recent policy and payment changes, as well as other factors affecting the use of imaging services. "In particular, the decline in ADI services occurred amid the implementation in recent years of public and private policies to slow rapid increases in imaging utilization and spending," the report stated.

For example, reductions in Medicare reimbursement could have contributed to the decline in advanced diagnostic imaging services in the period between 2009 and 2012, according to GAO. In addition, the increasing use of prior authorization policies by private payers could have curtailed these services, as well. GAO also noted that increased patient and physician awareness of the risks associated with radiation exposure could have led to a decline in CT and nuclear medicine services provided to Medicare beneficiaries.

The report concluded that although the impact of the accreditation requirement on access to advanced diagnostic imaging services remains unclear because its implementation coincided with these policy changes, "CMS officials, accrediting organization representatives, and accredited ADI suppliers we interviewed suggested that any effect on access was likely limited."

To learn more:
- see the 2012 Medicare accreditation requirement
- read the GAO report (.pdf)

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