High Cost - Low Return
Taken from the MedPAC “Report to Congress: Variation and Innovation in Medicare,” June 2003

Highlights of MedPAC Report
- Growth in the use of medical imaging services conducted by non-radiologists has shown high rates of growth compared to other services. In fact, medical imaging by physicians has grown 9.0 percent annually from 1999-2002. By contrast, all physician services grew by only 3.3 percent during the same time period.
- According MedPac, differences in spending among the states and other geographic areas were primarily due to greater use of discretionary services provided by physicians in those areas.
- Relatively high growth rates for imaging services are concentrated in several specific categories: nuclear medicine, CAT scans of parts of the body other than the head, MRI of parts of the body other than the brain, and MRI of the brain. Use of these services grew by 15 to 20 percent per year.
- On most measures of imaging service quality, care was no better in areas with high levels of spending than it was in areas with low levels of spending. On a few measures, quality was actually worse in high-spending areas. This may be the result of non-radiologists conducting tests using outdated or improper working equipment.
- MedPac also noted that areas with high levels of spending had slightly worse access on some measures. For example, among acute mycardinal infarction patients, those living in areas with higher spending were less likely to visit a physician within 30 days of hospital discharge than patients living in areas with lower spending.