A lot of hard hitting press about imaging costs manifested last week. A new Health Affairs study finds that imaging is contributing to dramatically higher annual costs to Medicare. The authors of the study, however, say it’s hard to address the “value” of imaging because of intangible benefits like ruling out disease. But their spin was about higher costs. They reported that the number of MRI procedures per 1,000 Medicare beneficiaries more than tripled from 50 in 1995 to 173 in 2005, the report found. The number of CT scans more than doubled in that period to 547. Of course morbidity and mortality went down during that same period, but no mention of that.

Meanwhile, MedPAC is considering recommending a change to physician reimbursement for imaging services out of their concern that the current structure offers an incentive to order unnecessary procedures. Commissioners at the November meeting discussed changing the equipment use rate for MRI and CT machines to either 75 percent or 90 percent of current rates.

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