The Harvey L. Neiman Health Policy Institute studies the value and role of radiology in evolving health care delivery and payment systems, including quality based approaches to care and the impact of medical imaging on overall health care costs. Neiman Institute research provides a foundation for evidence-based imaging policy to improve patient care and bolster efficient, effective use of health care resources. Read the 2016 Neiman Institute Annual Report.

August 11, 2017

Musculoskeletal Extremity Imaging in Medicare Beneficiaries Increased Over Two Decades

A new study by the Harvey L. Neiman Health Policy Institute™ found that in the Medicare population, the utilization rates have increased in both volume and per beneficiary over the past two decades for the four most common musculoskeletal (MSK) extremity imaging modalities: radiography, MRI, CT, and ultrasound. Radiology was the dominant billing specialty for all imaging modalities with dominant market shares for MRI and CT. Physician offices were the most common site for imaging for all modalities except for CT – which was most commonly utilized in the hospital outpatient and inpatient settings. These insights may have implications for radiology practice leaders in making decisions regarding capital infrastructure, workforce, and training investments to ensure the provision of optimal imagine services for extremity musculoskeletal care. The study is published online in the American Journal of Roentgenology.

“Our results show that the utilization rates (per 1,000 Medicare beneficiaries) for all four musculoskeletal extremity imaging modalities increased over time,” said lead study author Soterios Gyftopoulos, MD, an associate professor of radiology at NYU Langone Medical Center. “The largest increase was for CT throughout our study’s time-period with a 754% increase in utilization from 1994 to 2013.”

Gyftopoulos and his colleagues used billing data obtained from Centers for Medicare and Medicaid Services (CMS) Medicare Physician Supplier Procedure Summary Master Files from 1994 to 2013. The Neiman Imaging Types of Service (NITOS) radiology claims classification system was used to identify those HCPS codes corresponding with non-vascular extremity imaging. The following increases in MSK extremity imaging were found over the past two decades: 43% for radiography, 619% for MRI, 754% for CT, and 528% for ultrasound.

“An understanding of the utilization rates of common imaging modalities is an important first step towards determining the most cost-effective imaging strategies for patients with musculoskeletal conditions” added Richard Duszak, MD, FACR, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University and senior affiliate research fellow at the Neiman Institute. “Our findings support observations that physicians are increasingly relying on advanced imaging to ensure that their patients with musculoskeletal diseases receive the best care.”

To obtain a copy of the study or to arrange an interview with a Neiman Institute spokesperson, contact Nichole Gay at (703) 648-1665 or ngay@neimanhpi.org.

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About the Harvey L. Neiman Health Policy Institute
The Harvey L. Neiman Health Policy Institute is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care. Visit us at www.neimanhpi.org and follow us on TwitterLinkedIn and Facebook.

Contact

Nichole Gay
Harvey L. Neiman Health Policy Institute
703-648-1665
ngay@neimanhpi.com