title: Trends in the utilization of medical imaging from 2003 to 2011: clinical encounters offer a complementary patient-centered focus.
abstract: OBJECTIVE
  The aim of this study was to investigate trends in utilization and spending for medical imaging, using medical visits resulting in imaging as a novel metric of utilization.
  
  
  METHODS
  Utilization and spending for medical imaging were examined using (1) Medicare Part B claims data from 2003 to 2011 to measure per-enrollee spending and (2) household component events data on the elderly Medicare-age population from the Medical Expenditure Panel Survey from 2003 to 2010 to measure utilization as a function of clinical encounters.
  
  
  RESULTS
  Annual health spending and Medicare payments for imaging for the elderly population grew from $294 per enrollee in 2003 to $418 in 2006 and had declined to $390 by 2011. Over this entire time, however, annual medical visits by a similar Medicare-age (≥ 65 years old) population resulting in imaging trended consistently downward, from 12.8% in 2003 to 10.6% in 2011.
  
  
  CONCLUSIONS
  Despite early growth and then more recent declines in average Medicare spending per enrollee since 2003, the percentage of patient encounters resulting in medical imaging has significantly and consistently declined nationwide. Spending alone is thus an incomplete measure of changes in the role and utilization of medical imaging in overall patient care. As policymakers focus on medical imaging, a thoughtful analysis of payment policy influencing imaging utilization, and its role in concurrent and downstream patient care, will be critical to ensure appropriate patient access.
authors.affiliation: Harvey L. Neiman Health Policy Institute, Reston, Virginia 20191, USA. mdodoo@neimanhpi.org
authors.forename: Martey S
authors.initials: MS
authors.lastname: Dodoo
authors.forename: Richard
authors.initials: R
authors.lastname: Duszak
authors.forename: Danny R
authors.initials: DR
authors.lastname: Hughes
mesh_terms: D003952:Diagnostic Imaging / Q000191:economics* / Q000706:statistics & numerical data*; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data* / Q000639:trends*; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000191:economics* / Q000706:statistics & numerical data*; D014481:United States; D014600:Utilization Review