Decomposition of medical imaging spending growth between 2010 and 2021 in the US employer-insured population.

Health affairs scholar Pub Date : 2024-03-27 eCollection Date: 2024-03-01 DOI:10.1093/haschl/qxae030
Michal Horný, Daniel Chang, Eric W Christensen, Elizabeth Y Rula, Richard Duszak
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Abstract

Medical imaging, identified as a potential driver of unsustainable US health care spending growth, was subject to policies to reduce prices and use in low-value settings. Meanwhile, the Affordable Care Act increased access to preventive services-many involving imaging-for employer-sponsored insurance (ESI) beneficiaries. We used a large insurance claims database to examine imaging spending trends in the ESI population between 2010 and 2021-a period of considerable policy and benefits changes. Nominal spending on imaging increased 35.9% between 2010 and 2021, but as a share of total health care spending fell from 10.5% to 8.9%. The 22.5% growth of nominal imaging prices was below inflation, 24.3%, as measured by the Consumer Price Index. Other key contributors to imaging spending growth were increased use (7.4 percentage points [pp]), shifts toward advanced modalities (4.0 pp), and demographic changes (3.5 pp). Shifts in care settings and provider network participation resulted in 2.5-pp and 0.3-pp imaging spending decreases, respectively. In sum, imaging spending decreased as a share of all health care spending and relative to inflation, as intended by concurrent cost-containment policies.

2010 年至 2021 年美国雇主参保人群医疗成像支出增长分解图。
医学影像被认为是美国医疗支出不可持续增长的潜在驱动力,因此受到了降低价格和在低价值环境中使用的政策的影响。与此同时,《平价医疗法案》增加了雇主赞助保险(ESI)受益人获得预防性服务的机会,其中许多服务涉及影像检查。我们利用大型保险理赔数据库,研究了 2010 年至 2021 年期间 ESI 群体的影像学支出趋势--在此期间,政策和福利发生了巨大变化。2010 年至 2021 年期间,影像学的名义支出增长了 35.9%,但在医疗保健总支出中所占的比例却从 10.5% 降至 8.9%。成像名义价格增长 22.5%,低于消费价格指数衡量的通胀率 24.3%。造成成像支出增长的其他主要因素包括:使用量的增加(7.4 个百分点)、向先进模式的转变(4.0 个百分点)以及人口结构的变化(3.5 个百分点)。医疗机构和医疗服务提供者网络参与度的变化分别导致成像支出下降 2.5 个百分点和 0.3 个百分点。总之,影像学支出在所有医疗支出中所占的比例以及相对于通货膨胀率都有所下降,这也是同时实施的成本控制政策的初衷。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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