Imaging Volume Dip Could Signal Access Problems, Alliance Says

The volume of advanced imaging services for Medicare patients dipped for the first time in 11 years - a trend advocates say could point to patient access issues and lead to higher costs.

“We are very concerned about choking off access to these lifesaving technologies,” Tim, Trysla, executive director of the Access to Medical Imaging Coalition, said during a teleconference announcing the results.

According to a study released Wednesday by AMIC, the volume of advanced imaging services dropped slightly by 0.1 percent in 2009, compared with the previous year, and the amount of overall imaging services fell 7.1 percent. Spending for advanced imaging services in 2009 increased by 1.2 percent, less than half the 2.6 percent for overall physician services, said Don Moran, president of The Moran Company, which conducted the analysis.

The analysis examined Medicare claims data from 1999 to 2009, with a focus on spending and volume of advanced imaging, such as CT, MRI, and nuclear medicine including PET.

“It’s clear the era of very rapid growth in advanced medical imaging seems to have come to an end at this point in time,” Moran said during the teleconference.

Trysla said cuts in Medicare reimbursements threaten to restrict access to these advanced imaging services. He noted that the most recent cuts in the healthcare reform legislation were not considered in this study and could lead to further declines. Those policies could mean fewer available services, longer wait times, and a difficulty in early diagnosis, officials said.

David Fisher, executive director of the Medical Imaging and Technology Alliance, urged policymakers to consider the data in their decision making.

“Given that this decline coincides with a period when imaging was continuing to become increasingly integral to standards of care across a growing number of disease states,” he said in a statement, “we are concerned that patients will lose access, new innovation will be delayed, and that current technological innovations will not make it to patients if these trends continue, especially if the already radical decline in imaging growth is exacerbated by additional cuts.”

The decline in services is particularly troubling considering the growth in the Medicare population and the fact that the prevalence of disease is unchanged, said John A. Patti, MD, chair of the American College of Radiology board of chancellors, speaking on the teleconference.

“This decline is significant,” he said, adding that a dip in services suggests Medicare patients aren’t receiving the appropriate studies and “the benefits of early diagnosis.”

Patti said he was concerned the trend “might have negative downstream effects on the health of our aging citizens, and on the cost for the delivery of more complex care,” if diseases are not discovered until later stages.

However, this dip could be temporary, Patti said, adding that the growing Medicare population and unchanged disease prevalence will spur more growth in the future. “There may be other factors involved,” he said. “I don’t think there are any physicians who are taking direct care of patients who don’t understand the value of advanced imaging.”