According to a new study in Health Affairs, there has been a decline in the demand for imaging studies, which has led to a decrease in the demand for new radiologists. The study, which was conducted by a pair of health economics researchers, also found that growth in the use of magnetic resonance imaging (MRI) and computed tomography (CT) for patients in the United States slowed to between one-to-three percent per year between 2006 and 2009. This came after a decade of growth that exceeded six percent annually.
The authors, in the study, say several policies were the cause of this slowdown. “We hypothesize that higher cost sharing, prior authorization, reduced reimbursements, and fear of radiation are, for different parts of the population, countering some of the nonmedical incentives to order an imaging study,” the authors wrote. “What has occurred in the imaging field suggests incentive-based cost control measures can be a useful complement to comparative effectiveness research when a procedure’s ultimate clinical benefit is uncertain.”
The authors also say if their hypothesis is correct, the imaging field is “evidence that reducing nonmedical incentives to perform a procedure is a useful cost-control strategy, where a procedure’s ex ante clinical benefit is uncertain and clinical guidelines are hard to write.”
The authors looked at claims data for both the Medicare and non-Medicare patients from 2000 to 2009. For the Medicare population, use of CT grew at an annual rate of 14.3 percent from 2000 to 2005. Since 2005, however, it began declining each year, to the lowest increase of 1.4 percent in 2009. Meanwhile, MRI use in Medicare slowed from 14 percent annual growth between 2000 and 2005 to an average of 2.6 percent during 2006-09. The growth rate slowed similarly for non-Medicare patients, with the authors using data from 47 employer-sponsored plans.
There was an outlier finding. The authors found data from the single northeastern state showed that use of MRI increased at an annual rate of 5.6 percent during 2005–09. For the most part, however, it was a decline.