JACR: Nonradiologists drive musculoskeletal US growth
Article Thumbnail ImageFebruary 1, 2012 -- 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.
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  • 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
    2000 2009 Change
    Radiologists 40,877 91,022 123%
    Podiatrists 3,920 76,332 1,874%
    Rheumatologists 176 22,581 12,730%
    Primary care physicians 4,675 13,271 184%
    All other providers 7,606 30,758 304%

    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."


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