Demand for new radiologists, one of the most sought-after specialists, began declining in 2007 because of a lessening increase in demand for imaging studies. According to a Web First study in Health Affairs published yesterday, the growth in the use of magnetic resonance imaging (MRI) and computed tomography (CT) for patients in the United States slowed to between 1 and 3 percent per year between 2006 and 2009, ending a decade of growth that had exceeded 6 percent annually.

Authors David Lee and Frank Levy cite several policies that contributed to the slowdown. “We hypothesize that higher cost sharing, prior authorization, reduced reimbursements, and fear of radiation are, for different parts of the population, countering some of the nonmedical incentives to order an imaging study,” concluded the authors. “What has occurred in the imaging field suggests incentive-based cost control measures can be a useful complement to comparative effectiveness research when a procedure’s ultimate clinical benefit is uncertain.”

Lee heads health economics and reimbursement at GE Healthcare; Levy is a professor of urban economics at Massachusetts Institute of Technology and a lecturer at Harvard Medical School. To analyze the trends in utilization, they examined claims data for both the Medicare and non-Medicare patients from 2000 to 2009. For the Medicare population, use of CT grew at an annual rate of 14.3 percent from 2000 to 2005; the growth rate began declining each year after 2005, to the lowest increase of 1.4 percent in 2009. MRI use in Medicare slowed from 14 percent annual growth between 2000 and 2005 to an average of 2.6 percent during 2006-09. Among the commercially-insured nonelderly population there were similar utilization slowdowns detailed in the study.