Advanced diagnostic imaging in privately insured patients: Recent trends in utilization and payments

Michal Horný, James F. Burgess, Jedediah Horwitt, Alan B. Cohen

Research output: Contribution to journalArticle

Abstract

Recent studies have reported that the rate of growth in utilization of noninvasive diagnostic imaging has slowed, with a concomitant reduction in total payments to providers in the Medicare Part B fee-for-service population. Utilization and payment growth trends in commercially insured populations, however, are not as well understood. We used the Truven Health Analytics MarketScan® Commercial Claims and Encounters database containing more than 29 million individuals to investigate commercially insured population trends in utilization of and payments for CT, MRI, PET, and ultrasound procedures in the years 2007-2011. We found that imaging use - after a brief downturn in 2010 - rose again in 2011, coupled with substantial increases in adjusted payments for all four imaging modalities, raising concerns about future efforts to stem growth in imaging use and associated spending.

Original languageEnglish (US)
Pages (from-to)692-697
Number of pages6
JournalJournal of the American College of Radiology
Volume11
Issue number7
DOIs
StatePublished - Jul 2014

Keywords

  • Diagnostic imaging
  • commercial insurance
  • payments
  • utilization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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