Physician orders contribute to high-tech imaging slowdown.

The utilization rate of advanced diagnostic imaging (magnetic resonance imaging, computed tomography, and nuclear medicine) in Medicare outpatients rose 72.7 percent between 2000 and 2005, sparking concern among policymakers. However, analysis of discretionary use of these exams indicates that their use largely stabilized after 2005. Some have credited the Deficit Reduction Act of 2005, which sharply reduced reimbursements for advanced imaging done in physicians' offices. But the fact that the leveling was more pronounced in hospital outpatient facilities than in physicians' offices indicates that the explanation lies elsewhere. More likely, there has been a change in physicians' ordering patterns, possibly due to the influence of radiology business management companies (RBMs) and imaging guidelines promulgated by specialty societies.

[1]  J. Sunshine,et al.  Ownership or leasing of CT scanners by nonradiologist physicians: a rapidly growing trend that raises concern about self-referral. , 2008, Journal of the American College of Radiology : JACR.

[2]  A. Elster A Prior Authorization Program of a Radiology Benefits Management Company and How It Has Affected Utilization of Advanced Diagnostic Imaging , 2011 .

[3]  Jean M. Mitchell,et al.  Controlling the Escalating Use of Advanced Imaging , 2009, Medical care research and review : MCRR.

[4]  James H Thrall,et al.  Effect of computerized order entry with integrated decision support on the growth of outpatient procedure volumes: seven-year time series analysis. , 2009, Radiology.

[5]  Manesh R. Patel,et al.  ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. A report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group. , 2006, Journal of the American College of Radiology : JACR.

[6]  J. Iglehart Health insurers and medical-imaging policy--a work in progress. , 2009, The New England journal of medicine.

[7]  Jonathan H Sunshine,et al.  Ownership or leasing of MRI facilities by nonradiologist physicians is a rapidly growing trend. , 2008, Journal of the American College of Radiology : JACR.

[8]  A. Winter,et al.  Paying accurately for imaging services in medicare. , 2008, Health affairs.

[9]  Scott W Atlas,et al.  Expanded use of imaging technology and the challenge of measuring value. , 2008, Health affairs.

[10]  D. Berman,et al.  ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging: A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Associa , 2009, Journal of the American College of Cardiology.