Medical imaging use by Medicare beneficiaries has fallen since an early 2000s boom, a decline mirrored by recent lagging MRI and CT scanner sales from manufacturers, according to a report from the American College of Radiology's new think tank.

The report, the first from the newly minted Harvey L. Neiman Health Policy Institute, found that the dip in imaging coincides with patients staying longer at the hospital. While the institute can't show the two are related, it says the coincidence should at least dissuade lawmakers from promoting further imaging cuts until more research is done, as the growth of imaging last decade could have been contributing to better clinical outcomes or avoiding potentially higher downstream costs.

"Although many factors unrelated to medical imaging could very likely be at play (since such an association alone does not indicate causation), even the potential of such inverse relationships should give policy makers pause in continuing to pursue downward pressures on imaging utilization," writes report author Dr. Richard Duszak Jr., CEO and senior researcher with the HPI.

The Access to Medical Imaging Coalition, a lobby made up of patient advocacy groups and device manufacturers, echoed the report's warnings.

"It is essential that policymakers refer to the latest data on utilization and spending trends when contemplating cuts that would threaten patient access to life-saving imaging services," the group's executive director, Tim Trysla, said in a statement.

Decline and fall

Using Medical Expenditure Panel Survey data, the report found that medical visits with imaging dropped from more than 11 percent in 2000 to 10.4 percent in 2010. Meanwhile, the average length of a patient's hospital stay, a costly charge for Medicare, went up from 4.9 nights to 5.2 nights over the same period.

All told, utilization of medical imaging for Medicare Part B beneficiaries in 2010, by unit count, was 4.5 percent less than it was in 2006, while total Medicare Part B expenditures on diagnostic imaging declined by one-fifth from the 2006 peak.

Private insurers, mirroring public ones, also saw medical imaging utilization drop over 5 percent from 2009 to 2010, the report said.

AMIC said the findings also resemble a recent analysis from member organization Medical Imaging & Technology Alliance, an OEM trade group. MITA found that utilization per Medicare beneficiary declined 5 percent since 2009, while imaging spending per beneficiary fell 17 percent since 2006, AMIC said.

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