A group of radiology studies in the February issue of the Journal of the American College of Radiology suggest radiologists may be losing their foothold on the imaging industry, and that the trend in large part may be responsible for the rapid escalation of costs and usage associated with the technology.
The studies looked at a 10-year span of Medicare data and concluded that the largest growth in imaging billing can be attributed to studies performed by nonradiologists and in private-office settings. The first article, Recent Shifts in Place of Services for Noninvasive Diagnostic Imaging: Have Hospitals Missed an Opportunity? found that while utilization of imaging in private-office settings increased by 63% between 1996 and 2006, hospital imaging-centers market share decreased from 47% in 1996 to 41% in 2006. And though emergency departments saw the fastest growth in imaging procedures during that period77%utilization of imaging was substantially lower overall than in other settings.
A second article, Experience of an Academic Neuroradiology Division Participating in a Utilization Management Program, found that the use of evidence-based imaging guidelines under the direction of a radiology benefits-management program reduced the number of unnecessary imaging procedures performed. Fourteen percent of all procedures reviewed by the program were not performed and about 6% of all the ordered procedures were reordered using a more appropriate exam, according to the study.