Acquisition of MRI equipment by doctors drives up imaging use and spending

Health Affairs

Volumn 29, Issue 12, 2010, Pages 2252-2259

  Baker, Laurence C ^a  

^a STANFORD UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST; ECONOMICS; HOSPITAL PURCHASING; INSTRUMENTATION; INSURANCE; METHODOLOGY; NUCLEAR MAGNETIC RESONANCE IMAGING; PHYSICIAN; UNITED STATES; UTILIZATION REVIEW;

COSTS AND COST ANALYSIS; GROUP PURCHASING; INSURANCE CLAIM REVIEW; MAGNETIC RESONANCE IMAGING; PHYSICIANS; UNITED STATES;

EID: 79953793194     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2009.1099     Document Type: Article

References (26)

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17. To reduce the chance that movements of physicians across practices creates measurement errors, analyses here included only episodes where index visits took place in the eighteen months before and the eighteen months after the date on which the physician began billing for MRI.
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19. To access the Technical Appendix, click on the Technical Appendix link in the box to the right of the article online.
20. For orthopedists, 97 percent of procedures counted are MRI of the spine, upper extremities, or lower extremities. For neurologists, 97 percent of procedures counted are MRI of the brain or spine, or MR angiography of the head or neck.
21. Analyses of ninety-day spending used the same sample as previous analyses. Analyses of 365-day spending excluded episodes that started after January 1, 2005, and that thus could not be followed for an entire year after the index visit.
22. The estimate changes in MRI spending are generally consistent with the changes in MRI use reported above. For orthopedists, for example, an increase in 90-day MRI spending of $17 per episode, or $17,000 per 1,000 episodes, is comparable to an increase of 33 MRI procedures per 1,000 episodes over 90 days since Medicare paid $500- $600 per procedure for office-based imaging during this period. For neurologists, the increase in MRI spending is somewhat larger than can be explained by the change in MRI use reported above. It likely implies additional MRI procedures done by other doctors in addition to the increase of 56 per 1,000 associated with the index physician.
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