Elizabeth Morris1, Richard Duszak2, Akhilesh K Sista3, Jennifer Hemingway4, Danny R Hughes5, Andrew B Rosenkrantz6. 1. Department of Radiology, NYU Langone Health, New York, New York. 2. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia. 3. Division of Interventional Radiology, Department of Radiology, NYU Langone Health, New York, New York. 4. Harvey L. Neiman Health Policy Institute, Reston, Virginia. 5. Harvey L. Neiman Health Policy Institute, Reston, Virginia; School of Economics, Georgia Institute of Technology, Atlanta, Georgia. 6. Department of Radiology, NYU Langone Health, New York, New York. Electronic address: Andrew.Rosenkrantz@nyumc.org.
Abstract
PURPOSE: To assess trends in inferior vena cava (IVC) filter placement and retrieval procedures in Medicare beneficiaries over the last two decades. METHODS: Using Physician/Supplier Procedure Summary Master Files from 1994 through 2015, we calculated utilization rates for IVC filter placement and retrieval procedures in Medicare fee-for-service beneficiaries. Services were stratified by provider specialty group and site of service. RESULTS: IVC filter placement rates increased from 1994 to 2008 (from 65.0 to 202.1 per 100,000 beneficiaries, compound annual growth rate [CAGR] +8.4%) and then decreased to 128.9 by 2015 (CAGR -6.2%). This decrease was observed across all specialty groups and sites of service. From 1994 to 2015, placement procedure market share increased for radiologists (from 45.1% to 62.7%) and cardiologists (from 2.5% to 6.7%) but decreased for surgeons (from 46.6% to 27.9%). Overall, procedures shifted slightly from the inpatient (from 94.5% to 86.5% of all procedures) to outpatient hospital (from 4.9% to 14.9%) settings. Between 2012 and 2015, retrieval rates increased from 12.0 to 17.7 (CAGR +13.9%). Retrievals as a percentage of placement procedures were similar across specialties in 2015 (range 13.0%-13.8%). CONCLUSION: Despite prior dramatic growth, the utilization of IVC filters in Medicare beneficiaries markedly declined over the last decade, likely relating to evolving views regarding efficacy and long-term safety. This decline was accompanied by several filter-related market shifts, including increasing placement by radiologists and cardiologists, increasing outpatient placement procedures, and increasing retrieval rates.
PURPOSE: To assess trends in inferior vena cava (IVC) filter placement and retrieval procedures in Medicare beneficiaries over the last two decades. METHODS: Using Physician/Supplier Procedure Summary Master Files from 1994 through 2015, we calculated utilization rates for IVC filter placement and retrieval procedures in Medicare fee-for-service beneficiaries. Services were stratified by provider specialty group and site of service. RESULTS: IVC filter placement rates increased from 1994 to 2008 (from 65.0 to 202.1 per 100,000 beneficiaries, compound annual growth rate [CAGR] +8.4%) and then decreased to 128.9 by 2015 (CAGR -6.2%). This decrease was observed across all specialty groups and sites of service. From 1994 to 2015, placement procedure market share increased for radiologists (from 45.1% to 62.7%) and cardiologists (from 2.5% to 6.7%) but decreased for surgeons (from 46.6% to 27.9%). Overall, procedures shifted slightly from the inpatient (from 94.5% to 86.5% of all procedures) to outpatient hospital (from 4.9% to 14.9%) settings. Between 2012 and 2015, retrieval rates increased from 12.0 to 17.7 (CAGR +13.9%). Retrievals as a percentage of placement procedures were similar across specialties in 2015 (range 13.0%-13.8%). CONCLUSION: Despite prior dramatic growth, the utilization of IVC filters in Medicare beneficiaries markedly declined over the last decade, likely relating to evolving views regarding efficacy and long-term safety. This decline was accompanied by several filter-related market shifts, including increasing placement by radiologists and cardiologists, increasing outpatient placement procedures, and increasing retrieval rates.
Authors: Richard Duszak; Jennifer Hemingway; Eric W Christensen; Amit M Saindane; Danny R Hughes; Elizabeth Y Rula Journal: J Am Coll Radiol Date: 2022-05-25 Impact factor: 6.240
Authors: Matthew R Augustine; Erica M Knavel Koepsel; Lisa G Peterson; Laurie Rupkalvis; Ann Comstock; Ian McPhail; Robert D McBane; Haraldur Bjarnason; Damon E Houghton Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2021-09-03