title: Medicare Utilization of Vascular Ultrasound From 1998 to 2013: Continued Growth in Both Radiologist and Nonradiologist Imaging.
abstract: OBJECTIVE
  The aim of this study was to assess national trends in the utilization of vascular ultrasound (VUS) and changing relative specialty roles in examination interpretation.
  
  
  METHODS
  Service-specific claims data for VUS studies were identified using Medicare Physician Supplier Procedure Summary Master Files for the period from 1998 to 2013. Longitudinal national utilization rates were calculated using annual Medicare enrollment data for 1998 to 2012. Procedure volumes by specialty group and site of service were analyzed.
  
  
  RESULTS
  Total annual claims for VUS studies for Medicare fee-for-service beneficiaries increased from 4,422,360 to 8,599,677 (+94.5%) between 1998 and 2013. Per 1,000 beneficiaries, overall utilization rose from 145.93 in 1998 to 264.26 in 2012 (+81.1%). However, this peaked in 2009 at 270.43 and has been slowly declining each year since. Overall market share decreased from 43% to 41% for radiology and increased from 10% to 16% and from 9% to 17% for vascular surgery and cardiology, respectively. Compound adjusted growth rate increases were 4.2% for radiology, 7.8% for vascular surgery, and 8.7% for cardiology.
  
  
  CONCLUSIONS
  Utilization of VUS in the Medicare population increased from 1998 through 2009 but has been declining ever since. Although radiology has maintained the dominant market share over time, relative growth by cardiology and vascular surgery has outpaced that by radiology.
authors.affiliation: Department of Radiology, Division of Cardiovascular Imaging, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: aprabhakar@mgh.harvard.edu.
authors.forename: Anand M
authors.initials: AM
authors.lastname: Prabhakar
authors.affiliation: Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Misono
authors.affiliation: Harvey L. Neiman Health Policy Institute, Reston, Virginia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hemingway
authors.affiliation: Harvey L. Neiman Health Policy Institute, Reston, Virginia.
authors.forename: Danny R
authors.initials: DR
authors.lastname: Hughes
authors.affiliation: Harvey L. Neiman Health Policy Institute, Reston, Virginia; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Richard
authors.initials: R
authors.lastname: Duszak
mesh_terms: D006801:Humans; D006278:Medicare / Q000706:statistics & numerical data* / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D011871:Radiology / Q000706:statistics & numerical data* / Q000639:trends; D014463:Ultrasonography / Q000706:statistics & numerical data* / Q000639:trends; D014481:United States / Q000453:epidemiology; D014600:Utilization Review; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*
keywords: Medicare; Vascular ultrasound; cardiology; radiology; utilization; vascular surgery