Elizabeth T Loggers1, Paul A Fishman2, Do Peterson2, Maureen O'Keeffe-Rosetti2, Caprice Greenberg2, Mark C Hornbrook2, Lawrence H Kushi2, Sarah Lowry2, Arvind Ramaprasan2, Edward H Wagner2, Jane C Weeks2, Debra P Ritzwoller2. 1. Group Health Research Institute; Fred Hutchison Cancer Research Center, Seattle, WA; The Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Kaiser Permanente Northern California, Oakland, CA; Wisconsin Surgical Outcomes Research Program, University of Wisconsin-Madison, Madison, WI; Dana-Farber Cancer Institute-Harvard University, Boston, MA; and Institute for Health Research, Kaiser Permanente Colorado, Denver, CO Loggers.e@ghc.org. 2. Group Health Research Institute; Fred Hutchison Cancer Research Center, Seattle, WA; The Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Kaiser Permanente Northern California, Oakland, CA; Wisconsin Surgical Outcomes Research Program, University of Wisconsin-Madison, Madison, WI; Dana-Farber Cancer Institute-Harvard University, Boston, MA; and Institute for Health Research, Kaiser Permanente Colorado, Denver, CO.
Abstract
PURPOSE: Fee-for-service (FFS) Medicare expenditures for advanced imaging studies (defined as computed tomography [CT], magnetic resonance imaging [MRI], positron emission tomography [PET] scans, and nuclear medicine studies [NM]) rapidly increased in the past two decades for patients with cancer. Imaging rates are unknown for patients with cancer, whether under or over age 65 years, in health maintenance organizations (HMOs), where incentives may differ. MATERIALS AND METHODS: Incident cases of breast, colorectal, lung, prostate, leukemia, and non-Hodgkin lymphoma (NHL) cancers diagnosed in 2003 and 2006 from four HMOs in the Cancer Research Network were used to determine 2-year overall mean imaging counts and average total imaging costs per HMO enrollee by cancer type for those under and over age 65. RESULTS: There were 44,446 incident cancer patient cases, with a median age of 75 (interquartile range, 71-81), and 454,029 imaging procedures were performed. The mean number of images per patient increased from 7.4 in 2003 to 12.9 in 2006. Rates of imaging were similar across age groups, with the exception of greater use of echocardiograms and NM studies in younger patients with breast cancer and greater use of PET among younger patients with lung cancer. Advanced imaging accounted for approximately 41% of all imaging, or approximately 85% of the $8.7 million in imaging expenditures. Costs were nearly $2,000 per HMO enrollee; costs for younger patients with NHL, leukemia, and lung cancer were nearly $1,000 more in 2003. CONCLUSION: Rates of advanced imaging appear comparable among FFS and HMO participants of any age with these six cancers.
PURPOSE: Fee-for-service (FFS) Medicare expenditures for advanced imaging studies (defined as computed tomography [CT], magnetic resonance imaging [MRI], positron emission tomography [PET] scans, and nuclear medicine studies [NM]) rapidly increased in the past two decades for patients with cancer. Imaging rates are unknown for patients with cancer, whether under or over age 65 years, in health maintenance organizations (HMOs), where incentives may differ. MATERIALS AND METHODS: Incident cases of breast, colorectal, lung, prostate, leukemia, and non-Hodgkin lymphoma (NHL) cancers diagnosed in 2003 and 2006 from four HMOs in the Cancer Research Network were used to determine 2-year overall mean imaging counts and average total imaging costs per HMO enrollee by cancer type for those under and over age 65. RESULTS: There were 44,446 incident cancerpatient cases, with a median age of 75 (interquartile range, 71-81), and 454,029 imaging procedures were performed. The mean number of images per patient increased from 7.4 in 2003 to 12.9 in 2006. Rates of imaging were similar across age groups, with the exception of greater use of echocardiograms and NM studies in younger patients with breast cancer and greater use of PET among younger patients with lung cancer. Advanced imaging accounted for approximately 41% of all imaging, or approximately 85% of the $8.7 million in imaging expenditures. Costs were nearly $2,000 per HMO enrollee; costs for younger patients with NHL, leukemia, and lung cancer were nearly $1,000 more in 2003. CONCLUSION: Rates of advanced imaging appear comparable among FFS and HMO participants of any age with these six cancers.
Authors: Debra P Ritzwoller; Nikki Carroll; Thomas Delate; Maureen O'Keeffe-Rossetti; Paul A Fishman; Elizabeth T Loggers; Erin J Aiello Bowles; Jennifer Elston-Lafata; Mark C Hornbrook Journal: Med Care Date: 2013-10 Impact factor: 2.983
Authors: Elena Birman-Deych; Amy D Waterman; Yan Yan; David S Nilasena; Martha J Radford; Brian F Gage Journal: Med Care Date: 2005-05 Impact factor: 2.983
Authors: Mark C Hornbrook; Gene Hart; Jennifer L Ellis; Donald J Bachman; Gary Ansell; Sarah M Greene; Edward H Wagner; Roy Pardee; Mark M Schmidt; Ann Geiger; Amy L Butani; Terry Field; Hassan Fouayzi; Irina Miroshnik; Liyan Liu; Robert Diseker; Karen Wells; Rick Krajenta; Lois Lamerato; Christine Neslund Dudas Journal: J Natl Cancer Inst Monogr Date: 2005
Authors: Hude Quan; Vijaya Sundararajan; Patricia Halfon; Andrew Fong; Bernard Burnand; Jean-Christophe Luthi; L Duncan Saunders; Cynthia A Beck; Thomas E Feasby; William A Ghali Journal: Med Care Date: 2005-11 Impact factor: 2.983
Authors: K Robin Yabroff; Elizabeth B Lamont; Angela Mariotto; Joan L Warren; Marie Topor; Angela Meekins; Martin L Brown Journal: J Natl Cancer Inst Date: 2008-04-29 Impact factor: 13.506
Authors: Jessica Chubak; Rebecca Ziebell; Robert T Greenlee; Stacey Honda; Mark C Hornbrook; Mara Epstein; Larissa Nekhlyudov; Pamala A Pawloski; Debra P Ritzwoller; Nirupa R Ghai; Heather Spencer Feigelson; Heather A Clancy; V Paul Doria-Rose; Lawrence H Kushi Journal: Cancer Causes Control Date: 2016-09-17 Impact factor: 2.506
Authors: Debra P Ritzwoller; Nikki M Carroll; Thomas Delate; Mark C Hornbrook; Lawrence Kushi; Erin J Aiello Bowles; Elizabeth T Loggers; Alex Menter Journal: J Thorac Oncol Date: 2014-05 Impact factor: 15.609
Authors: Debra P Ritzwoller; Paul A Fishman; Matthew P Banegas; Nikki M Carroll; Maureen O'Keeffe-Rosetti; Angel M Cronin; Hajime Uno; Mark C Hornbrook; Michael J Hassett Journal: Health Serv Res Date: 2018-07-24 Impact factor: 3.402
Authors: Jennifer L Caswell-Jin; Alison Callahan; Natasha Purington; Summer S Han; Haruka Itakura; Esther M John; Douglas W Blayney; George W Sledge; Nigam H Shah; Allison W Kurian Journal: JCO Clin Cancer Inform Date: 2021-05