Reimbursement cuts correlate with shift of outpatient MRI exams from private offices to hospitals

Recent imaging reimbursement cuts have correlated with a shift of more outpatient MRI exams being performed in hospital outpatient departments than private offices, according to a study published online in the Journal of the American College of Radiology.

The study, led by David Levin, M.D. of the department of radiology at Thomas Jefferson University in Philadelphia, used Medicare Part B Physician/Supplier Procedure Summary Master Files to study total MRI volumes from 2002 to 2012.

Levin and his colleagues found that Medicare office and hospital outpatient department utilization of MRI rose rapidly between 2002 and 2006 when the number of MRI studies performed in offices outnumbered those in hospital outpatient departments 2,727,807 to 2,355,641.

In 2007, the Deficit Reduction Act went into effect, which, according to this 2012 study by Levin and his colleagues, had the effect of sharply reducing technical component payments for advanced imaging in private offices. Since then, radiologists and imaging centers have constantly struggled with MRI reimbursement cuts.

In the current study, Levin and his colleagues found that after 2006, MRI office volume steadily declined while hospital outpatient volume steadily increased; by 2012, the number of MRI exams being performed in hospital outpatient departments actually surpassed the number performed in officers.

Levin and his colleagues also found that between 2002 and 2012, the office MRI volume among radiologists increased by 27 percent, compared with more than 216 percent for orthopedic surgeons and 124 percent for other physicians.

The shift in the percentage of exams being performed in hospital outpatient departments compared to private offices means higher costs for payers, the researchers concluded, since reimbursements to hospital outpatient departments generally are higher than reimbursements to offices.

To learn more:
- here's the study in the JACR
- check out the 2012 study