The sharp slowdown in growth of medical imaging: An early analysis suggests combination of policies was the cause

Health Affairs

Volumn 31, Issue 8, 2012, Pages 1876-1884

  Lee, David W ^a   Levy, Frank ^b  

^a GE HEALTHCARE   (United States)

^b MASSACHUSETTS INSTITUTE OF TECHNOLOGY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMPUTER ASSISTED TOMOGRAPHY; DIAGNOSTIC IMAGING; HEALTH CARE COST; HEALTH CARE PERSONNEL; HEALTH CARE POLICY; HEALTH CARE UTILIZATION; HUMAN; INTERVIEW; MEDICARE; NUCLEAR MAGNETIC RESONANCE IMAGING; RADIOLOGIST;

DIAGNOSTIC IMAGING; ECONOMIC RECESSION; HEALTH POLICY; HUMANS; INSURANCE CLAIM REVIEW; INSURANCE, HEALTH; INSURANCE, HEALTH, REIMBURSEMENT; MAGNETIC RESONANCE IMAGING; MEDICARE; QUALITATIVE RESEARCH; TOMOGRAPHY, X-RAY COMPUTED; UNITED STATES;

EID: 84866327617     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2011.1034     Document Type: Article

References (45)

1. We measured utilization as the annual number of imaging studies per 1,000 insured individuals. An imaging study-for example, a CT scan of the abdomen-contains multiple cross-sectional images.
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3. An example of marketing profit opportunities for in-office equipment is Siemens' brochure for in-office computed tomography for urologists. Siemens Medical Solutions. Imaging opportunities for urology physician practices: affordable inoffice computed tomography solutions [Internet]. Malvern (PA): Siemens Medical Solutions; 2006 [cited 2012 Jun 29]. Available from: http://www.medical.siemens.com/siemens/en_US/rg_marcom_FBAs/files/brochures/cs_diagnostic/061PC289v8.pdf
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6. The recession undoubtedly contributed to this softness as people lost health insurance. The loss of insurance, however, should not have affected our analysis of utilization, because utilization is defined as imaging studies per 1,000 insured people.
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19. We thank Jonathan Sunshine of the Urban Institute, formerly research director of the American College of Radiology, for these data
20. To access the Appendix, click on the Appendix link in the box to the right of the article online
21. After 2008, the American College of Radiology no longer collected data in this form
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29. Many other people lost all health insurance in the recession, but these losses should not have affected the data presented here, which measure imaging studies per 1,000 insured people
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32. In some cases, increased cost sharing can apply specifically to imaging. A benefit manager described the evolution of his firm's health insurance in which imaging for prevention without a diagnosis went from no deductible or copayment in 2008 to a copay in 2009, a copay and deductible in 2010, and a deductible and increased copay in 2011. Overall imaging use declined during the period.
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36. Our commercial samples do not identify place of service
37. Specifically, annual growth in CT use slowed from 10 percent to 6 percent in hospital outpatient facilities versus percent to 4 percent per year in imaging centers and physicians' offices, while annual growth in MRI use slowed from 6 percent to 3 percent in hospital outpatient facilities versus 7 percent to -1 percent in imaging centers and physicians' offices
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40. The utilization slowdown equals this volume slowdown, divided by the growth in beneficiaries.We choose 2002-06 for our baseline because our data on a commercially insured population extend back only to 2002.
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