Imaging Not to Blame for Rapid Rise in Cost of Care, Medicare Data Shows

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Old perceptions die hard, but a new report from Richard Duszak, MD, FACR, could go a long way toward finally ending the notion that imaging is responsible for rapidly rising health care costs. The seven-page report, entitled Medical Imaging: Is the Growth Boom Over?, is a comprehensive analysis that draws on Medicare's own data to show that imaging use is down nearly 5% since 2006, and spending on imaging is down dramatically (21%) over the same span.

“The belief that imaging is growing, and is a huge driver of health care costs, is just a myth in the current state of affairs,” said Duszak, CEO and senior research fellow, Harvey L. Neiman Health Policy Institute. “Our goal is to make sure that the information is realistic and credible, and that people are making policy decisions based on real information, rather than 5- or 6-year-old information.”

In an American College of Radiology press call Tuesday, Duszak pointed out that radiology has experienced a whopping $6 billion in Medicare cuts for imaging services since 2006, one of many reasons for the reduction in utilization. “Imaging funding has also been cut seven times in the last 6 years,” he added. “There has been greater use of evidence-based ACR appropriateness criteria, and electronic physician order entry systems based on these guidelines—which ensure that patients get the right scan for the right indication and avoid unnecessary scans.”

Duszak predicts that practicing radiologists will not be surprised by the report, since “those of us in the trenches” have seen the “growth boom” moving in the opposite direction for quite a while. “One of the reasons we chose this as our first priority is that a lot of people outside radiology are not seeing these trends or living them on a day-to-day basis,” said Duszak. “We finally have an opportunity to show people in a demonstrative and unequivocal way what we [radiologists] have all known for quite a while.”

In an incidental finding of sorts, Duszak discovered that the average length of a hospital stay went up (from 4.9 days to 5.2 days) when imaging went down. The calculation was not part of the formal analysis, but Duszak reasoned that if the trend could be confirmed, it would mean annual added costs of $17 billion to $21 billion.

“If future research demonstrates causation, rather than mere association, this would mean that for every dollar saved in imaging, the health care system may actually be unnecessarily spending another $3 downstream,” explained Duszak. “The fact that this trend coincides with the drop in imaging is relevant.”

Access the full report here.