Journal of the American College of Radiology
Volume 6, Issue 6 , Pages 437-441 , June 2009

Recent Payment and Utilization Trends in Radionuclide Myocardial Perfusion Imaging: Comparison Between Self-Referral and Referral to Radiologists

  • David C. Levin, MD

      Affiliations

    • Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania
    • HealthHelp, Inc., Houston, Texas
    • Corresponding Author InformationCorresponding author and reprints: David C. Levin, MD, Thomas Jefferson University Hospital, Department of Radiology, Main 1090, Philadelphia, PA 19107
    • ,
  • Vijay M. Rao, MD

      Affiliations

    • Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania
    • ,
  • Laurence Parker, PhD

      Affiliations

    • Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania
    • ,
  • Andrea J. Frangos, MS

      Affiliations

    • Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania
    • ,
  • Charles M. Intenzo, MD

      Affiliations

    • Center for Research on Utilization of Imaging Services, Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania

References 

  1. Winter A, Stensland J. Introduction: expert panel on new research on use of imaging services. http://www.medpac.gov/transcripts/imaging%20expert%20panel_sept%2008_public.pdfAccessed October 13, 2008
  2. Levinson DR. Growth in advanced imaging paid under the Medicare physician fee schedule. http://www.oig.hhs.gov/oei/reports/oei-01-06-00260.pdfAccessed October 13, 2008
  3. US Government Accountability Office. Medicare Part B imaging services: rapid spending growth and shift to physician offices indicate need for CMS to consider additional management practices. http://www.gao.gov/new.items/d08452.pdfAccessed October 13, 2008
  4. Levin DC, Rao VM. Turf wars in radiology: the overutilization of imaging resulting from self-referral. J Am Coll Radiol. 2004;1:169–172
  5. Levin DC, Rao VM. Turf wars in radiology: updated evidence on the relationship between self-referral and the overutilization of imaging. J Am Coll Radiol. 2008;5:652–656
  6. Gazelle GS, Halpern EF, Ryan HS, Tramontano AC. Utilization of diagnostic medical imaging: comparison of radiologist referral versus same-specialty referral. Radiology. 2007;245:517–522
  7. Hillman BJ, Joseph CA, Mabry MR, Sunshine JH, Kennedy SD, Noether M. Frequency and costs of diagnostic imaging in office practice—a comparison of self-referring and radiologist-referring physicians. N Engl J Med. 1990;323:1604–1608
  8. Hillman BJ, Olson GT, Griffith PE, et al. Physicians' utilization and charges for outpatient diagnostic imaging in a Medicare population. JAMA. 1992;268:2050–2054
  9. Mitchell JM. The prevalence of physician self-referral arrangements after Stark II: evidence from advanced diagnostic imaging. Health Aff (Millwood). 2007;26:w415–w424http://content.healthaffairs.org/cgi/content/abstract/hlthaff.26.3.w415Accessed December 28, 2007
  10. Mitchell JM. Utilization trends for advanced imaging procedures: evidence from individuals with private insurance coverage in California. Med Care. 2008;46:460–466
  11. Levin DC, Rao VM, Parker L, Frangos AJ, Sunshine JH. Ownership or leasing of MRI facilities by nonradiologist physicians is a rapidly growing trend. J Am Coll Radiol. 2008;5:105–109
  12. Levin DC, Intenzo CM, Rao VM, Frangos AJ, Parker L, Sunshine JH. Comparison of recent utilization trends in radionuclide myocardial perfusion imaging among radiologists and cardiologists. J Am Coll Radiol. 2005;2:821–824
  13. Gibbons RJ, Miller TD, Hodge D, et al. Application of appropriateness criteria to stress single-photon emission computed tomography sestamibi studies and stress echocardiograms in an academic medical center. J Am Coll Cardiol. 2008;51:1283–1289

 This study was supported in part by a grant from the American College of Radiology (Reston, Va).

PII: S1546-1440(08)00660-1

doi: 10.1016/j.jacr.2008.12.015

Journal of the American College of Radiology
Volume 6, Issue 6 , Pages 437-441 , June 2009

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