Cardiologists are performing fewer in-office imaging exams now than in the past, according to a new study published in Radiology: Cardiothoracic Imaging. Radiologists in hospital outpatient departments (HOPDs) appear to have picked up the slack.
The study’s authors noted that reimbursement cuts related to the Deficit Reduction Act (DRA) of 2005 played a key role in this shift.
“In the early 2000s, cardiology office imaging utilization was skyrocketing,” lead author Russell A. Reeves, MD, from the Center for Research on Utilization of Imaging Service (CRUISE) and diagnostic radiology resident in the department of radiology at Thomas Jefferson University in Philadelphia, said in a statement. “The changes brought by DRA reversed that trend to where it no longer was lucrative or even feasible for a lot of cardiologists to do imaging in their offices.”
Reviewing Physician Supplier Procedure Summary data on Medicare beneficiaries from 2010 to 2019, Reeves and colleagues found that in-office myocardial perfusion imaging rates for cardiologists dropped 52% over that ten-year period. Imaging rates at HOPDs, meanwhile, increased 71%.
In addition, coronary computed tomography angiography (cCTA) rates by radiologists at HOPDs increased by a whopping 355% from 2010 to 2019. Utilization is still low compared to myocardial perfusion imaging, but some recent studies have found that it is the more accurate imaging option.
“Coronary CTA is a useful screening tool for coronary artery disease that obviates the need for invasive coronary angiography,” Reeves said. “I think the future is looking favorably on it.”
Cardiac PET in cardiologist offices did increase by 193% over the course of the study, providing the authors with an exception to the overall trend. Reeves noted that this is likely due to multiple factors, including advances in office technology and financial incentives.
The full analysis can be read here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.