Anand M Prabhakar1, Alexander S Misono2, Jennifer Hemingway3, Danny R Hughes4, Richard Duszak5. 1. Division of Cardiovascular Imaging, 55 Fruit Street, Gray 2, Boston, MA 02114. Electronic address: aprabhakar@mgh.harvard.edu. 2. Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Reston, Virginia. 3. Harvey L. Neiman Health Policy Institute, Reston, Virginia. 4. Harvey L. Neiman Health Policy Institute, Reston, Virginia; Department of Health Administration and Policy, George Mason University, Fairfax, Virginia. 5. Harvey L. Neiman Health Policy Institute, Reston, Virginia; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Abstract
PURPOSE: To examine changes in utilization of computed tomography (CT) angiography nationally and changing relative specialty roles in examination interpretation. MATERIALS AND METHODS: Service-specific claims data for region-specific CT angiography examinations were identified using Medicare Physician Supplier Procedure Summary Master Files from 2001 through 2014. Longitudinal national utilization rates were calculated using annual Medicare enrollment data for 2001-2013. Procedure volumes by specialty group and site of service were analyzed. RESULTS: Total annual claims for CT angiography for Medicare fee for service beneficiaries increased from 64,846 to 1,709,088 (compound annual growth rate [CAGR] 29%) between 2001 and 2014. Per 1,000 beneficiaries, overall CT angiography utilization increased annually from 2.1 in 2001 to 47.6 in 2013. Overall interpretation market share increased 4% (91%-95%) for radiology. Cardiology increased from 1% in 2001 to 6% in 2007 but decreased annually to 2% in 2014. Vascular surgery market share remained < 1% throughout the study period. Growth of CT angiography in the emergency department (ED) outpaced all other sites of service, increasing from 11% to 28% (CAGR 38%). The chest was the dominant body region imaged with CT angiography, increasing from 36,984 to 914,086 (CAGR 28%). CONCLUSIONS: Utilization of CT angiography in the Medicare population increased markedly for 2001-2014, particularly in the ED, with radiologists remaining dominant providers. The chest is the most common body region imaged with CT angiography.
PURPOSE: To examine changes in utilization of computed tomography (CT) angiography nationally and changing relative specialty roles in examination interpretation. MATERIALS AND METHODS: Service-specific claims data for region-specific CT angiography examinations were identified using Medicare Physician Supplier Procedure Summary Master Files from 2001 through 2014. Longitudinal national utilization rates were calculated using annual Medicare enrollment data for 2001-2013. Procedure volumes by specialty group and site of service were analyzed. RESULTS: Total annual claims for CT angiography for Medicare fee for service beneficiaries increased from 64,846 to 1,709,088 (compound annual growth rate [CAGR] 29%) between 2001 and 2014. Per 1,000 beneficiaries, overall CT angiography utilization increased annually from 2.1 in 2001 to 47.6 in 2013. Overall interpretation market share increased 4% (91%-95%) for radiology. Cardiology increased from 1% in 2001 to 6% in 2007 but decreased annually to 2% in 2014. Vascular surgery market share remained < 1% throughout the study period. Growth of CT angiography in the emergency department (ED) outpaced all other sites of service, increasing from 11% to 28% (CAGR 38%). The chest was the dominant body region imaged with CT angiography, increasing from 36,984 to 914,086 (CAGR 28%). CONCLUSIONS: Utilization of CT angiography in the Medicare population increased markedly for 2001-2014, particularly in the ED, with radiologists remaining dominant providers. The chest is the most common body region imaged with CT angiography.