Nonradiologists -- podiatrists, in particular -- are dramatically increasing their utilization of musculoskeletal ultrasound, according to an analysis of Medicare data published in the February issue of the Journal of the American College of Radiology.
Thanks to dramatic growth in use by nonradiologists, radiologists performed less than 40% of musculoskeletal ultrasound procedures paid for by Medicare in 2009, down from close to 75% in 2000, according to a team of researchers from Thomas Jefferson University.
"In a healthcare climate in which increased utilization deserves further scrutiny, this study has demonstrated significant utilization increases by specialties that are not traditional imaging providers and may be in a position to self-refer," wrote a team led by Dr. Richard Sharpe (JACR, February 2012, Vol. 9:2, pp. 141-146).
The researchers analyzed data from the U.S. Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Procedure Summary Master Files for 2000 to 2009. In 2009, 233,964 musculoskeletal ultrasound procedures were performed, up 316% from the 56,254 performed in 2000.
Medicare MSK ultrasound use by provider type
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While radiologists accounted for 72.7% of procedures in 2000, they only produced 38.9% of the studies in 2009. The increased volume from radiologists contributed 28.2% of the musculoskeletal ultrasound procedure growth from 2000 to 2009.
Even higher growth rates were seen in private offices. Private-office musculoskeletal ultrasound procedures reached 158,531 in 2009, up 717% from the 19,372 exams performed in 2000.
Nearly half (75,544) of the private-office procedures in 2009 were performed by podiatrists, up from 3,913 in 2000. Rheumatologists also saw a big increase in utilization, climbing from 176 private-office musculoskeletal ultrasound procedures to 22,517 in 2009.
"Other types of providers accounted for comparatively less new volume," the authors wrote. "Radiologists' growth from 2000 to 2009 accounted for 9.2% of the total growth in private-office MSK ultrasound utilization during this time period."
