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Medical imaging use declines as hospital admissions climb

by Brendon Nafziger, DOTmed News Associate Editor | October 23, 2012

Boom years

Overall, the HPI report suggests that the imaging growth rate for Part B Medicare beneficiaries grew rapidly in the early part of last decade, before peaking in 2005. Between 2003 and 2006, for instance, imaging services for beneficiaries rose 58 percent, from 206 million services to 326 million services. Other services grew at a much slower rate: lab tests only grew 14 percent and evaluation and management 5 percent, the report said.

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The report credits the boom years to a variety of factors, from doctors practicing defensive medicine to avoid lawsuits and new clinical indications and advances in technology, to financial conflicts of interest for doctors who self-refer.

In any case, by 2006 things were changing. The Deficit Reduction Act and a raft of other imaging cuts, largely to the technical component paid to imaging clinics, market saturation, maturation of technologies like CT and MRI and even better awareness of radiation risks among patients, all probably led to a decline. For CT use, for instance, which grew 14 percent every year from 2000 through 2005, growth slowed dramatically, falling to 7 percent in 2006 and just over 1 percent in 2009. Notably, in recent years the Medicare professional component for CT services has been cut by one-fifth and the technical component to imaging centers by almost one-half, the report said.

Equipment sales hurt too

As utilization declined, so did equipment sales. During the boom years, from 1993 to 2006, sales of CT and MRIs nearly tripled every year, according to the report. But from 2006 to 2008, CT sales dropped 27 percent and MRI sales 36 percent.

"Although more recent manufacturer data are not publicly available, these trends will likely continue and suggest impending market saturation," Duszak writes. "In an environment in which increasing numbers of private imaging centers are closing or being sold off to hospital systems, such declines portend an overall declining market capacity for medical imaging for the foreseeable future."

The report is "Medical imaging: Is the growth boom over?"

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