MedPAC: Despite temporary drop, overall imaging volume up for the decade

While the imaging volume for Medicare beneficiaries temporarily fell from 2011 to 2012, the level at which these services are being used is still much higher than it was a decade ago.

According to the Medicare Payment Advisory Commission's (MedPAC) recently published annual report to Congress, imaging volume decreased by 3.2 percent from 2011 to 2012. MedPAC noted that while imaging had a negative growth from 2011 to 2012, that decrease did "not raise concerns about access to these services." The agency wrote that the decrease occurred "amid concerns about overuse of the services" and that it reflected a shift in billing for cardiac imaging from professionals' offices to hospitals.

Research published in the December 2013 issue of the American Journal of Roentgenology confirmed that medical imaging was a major contributor to the growth in Medicare spending in the first decade of the 21st Century but also found that imaging now ranks near the bottom of Medicare spending categories.

In its report MedPAC emphasized that between 2000 and 2009, imaging volume increased by 85 percent. And while imaging volume has decreased by 7 percent since 2009, "the use of imaging services has remained much higher than it was a decade ago," according to the report.

In fact, MedPAC reported, the "growth in imaging volume from 2000 to 2009 was exceeded only by the 86 percent growth in use of tests--such as allergy tests--in those years." This growth, MedPAC wrote, also was more than double the cumulative growth of evaluation and management services and major procedures.

The report went on to detail studies and reports on issues of inappropriate imaging, overuse of modalities like CT and MRI, and unnecessary testing involving services such as echocardiography, imaging stress tests and chest CT.

"Meanwhile, physicians and others continue to raise concerns about overuse of imaging, including the exposure to radiation that can accompany that overuse. Some physician organizations have responded to these concerns," MedPAC wrote, pointing to the Choosing Wisely initiative as an example.

To learn more:
- see the MedPAC annual report (.pdf)

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