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Study Shows Tiny Decline In Advanced Imaging

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In 2009, for the first time in 11 years, the volume of advanced imaging services for Medicare beneficiaries decreased, according to a new study released this week by the Access to Medical Imaging Coalition (AMIC).

It decreased only a bit, just 0.1 percent. But the Medicare study contained lots more gloomy news. From 2008 to 2009:

  • The volume of overall (not just advanced) imaging services declined by 7.1 percent.
  • Overall spending on imaging decreased 2.1 percent, from $12 billion to $11.8 billion. Spending for advanced imaging did increase 1.2 percent, though it remained well below its 2006 peak.
  • MRI volume dropped by 1.2 percent.
  • Volume for screening mammography decreased by a third of 1 percent.
  • Volume for DXA bone scans decreased 2.2 percent.

The study, done by The Moran Company of Washington, DC, examined services billed to Medicare Part B carriers under the physician fee schedule from 1999 through 2009. It defined “advanced imaging” as MRI, CT, and nuclear medicine, including PET and CT/PET.

It found that the peak for imaging volume occurred in 2005-2006. After that, the Deficit Reduction Act of 2005 took effect, cutting nonhospital imaging reimbursements. Spending on advanced imaging services decreased almost 20 percent from 2006 to 2007, according to the study.

“The decline in volume of critical screening services suggests that access issues are at hand,” said Tim Trysla, executive director of AMIC. “While imaging has been proven to reduce mortality, additional cuts to Medicare reimbursements threaten to continue the current trajectory and further restrict patient access to lifesaving diagnostic tools and screening services.”

Trysla was quoted in an AMIC news release. The organization is a lobbying group for doctor, patient, and imaging manufacturer groups.

DOTmed News quoted John A. Patti, MD, chair of the American College of Radiology (ACR) Board of Chancellors, as saying:

We are very concerned with this decline because, first of all, the incidence and prevalence of disease in the population has not declined and, secondly, because the Medicare population is increasing.

Pressure on health-care costs will, of course, probably get even more intense. AMIC supports appropriateness guidelines for imaging, such as those proposed by the ACR. However, it considers cuts targeting imaging centers—by the Deficit Reduction Act and by the Centers for Medicare & Medicaid Services—as blunt instruments that threaten to reduce patient access to imaging.

“From a patient-care perspective, we’re very troubled by this trend,” Dr. Patti said. “We’ll just have to wait and see if it continues or not.”

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