The number of computed tomography (CT) procedures being performed in the U.S. has declined by an annual rate of 5.5 percent over the last two years, according to a survey by IMV Medical Information Division. The drop represents a complete reversal of growth activity that took place in the early 2000s; from 2007 to 2011, use of such tests increased at an average annual rate of 5.6 percent.
Lorna Young, senior director of market research at IMV, asserts that the decline coincides with reimbursement issues.
"This apparent decline in CT procedures over the past couple years may in part be due to the reimbursement policies of Medicare and third-party insurers, who have tightened their reimbursements for key CT studies," Young says in an announcement.
According to the report, CT procedures involving the chest/abdomen/pelvis categories declined from 46 percent of the total number of CT procedures to 38 percent because of changes to the payment structure for combined studies for chest/abdomen/pelvis contiguous scans. In addition, the payment structure of head CT studies without contrast has changed, leading to a decrease in the number of the procedures per patient.
Independent imaging centers, the report's authors say, have been hit hard and have particular concerns about managing their bottom lines; their survey responses indicate that reductions in Medicare and third-party reimbursement caused their CT revenues to decline last year. This may explain why only about 20 percent of these centers plan on making CT purchases, although they account for about one-third of all CT sites.
In addition, it appears that uncertainty about the impact of federal healthcare reform also is affecting spending on new capital equipment. About two-thirds of respondents answered yes to a survey question asking "whether the impact of federal healthcare reform is so uncertain that our facility has slowed the rate of all capital equipment spending until we know what the outcome is."
The IMV report is in line with other studies showing a decline in advanced imaging utilization rates. At RSNA 2013 David Levin, M.D., presented a study showing that after years of rising, CT utilization rates began falling in 2010, mostly because of code bundling for abdomen and pelvis CT.