Med imaging near bottom of services adding to growth in Medicare spending

While medical imaging was a major contributor to the growth in Medicare spending in the first part of the 21st Century, it now ranks near the bottom of Medicare spending categories, according to a study in the December issue of the American Journal of Roentgenology.

Medicare outlays for imaging services grew by 12 percent in the period between 2000 and 2006 (when the Deficit Reduction Act went into effect), compared to 6.8 percent for non-imaging services, according to the researchers, including Richard Duszak and Danny R. Hughes of the Harvey L. Neiman Health Policy Institute. However, over the next five years, annual growth in nonimaging services grew at 3.6 percent, while the growth in imaging services declined 3.5 percent annually. The spending growth for all services during the pre-DRA, DRA and post-DRA periods was 7.8 percent, 3.8 percent, and 2.9 percent respectively, compared to 15 percent, negative-3.4 percent, and negative-2.2 percent for advanced imaging.

While the growth in imaging services declined between 2007 and 2011, the fastest growing service categories were evaluation and management services with other specialists (29.1 percent), nursing home visits (11.2 percent), anesthesia (9.1 percent), and other ambulatory procedures (9.0 percent).

"As a result of the slowdown in Medicare spending on imaging, other nonimaging services are now contributing much more to the overall increase in Medicare spending," the study's authors wrote. "Policy makers seeking further reductions in healthcare spending should consider directing future cost cutting initiatives toward these now-leading service categories."

According to the researchers, slowing volume growth as well as "massive" Medicare payment cuts account for the slowdown in imaging growth.

"It is important to shed light on such relative changes in spending, because policy makers who are interested in bending the cost curve typically focus their attention on services that are growing most rapidly and not necessarily just those with the largest absolute spending," Hughes said in an announcement. "This research provides those policy makers with an important piece of the puzzle, one that will be fundamental to understanding the bigger picture of Medicare spending moving forward."

To learn more:
- see the study in the American Journal of Roentgenology
- see the announcement

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