Press Release  MA RANKS AS THE 4TH HIGHEST STATE IN MEDICARE SPENDING FOR MEDICAL IMAGING SERVICES

Boston — Friday, May 4, 2018

Today, the Massachusetts Health Policy Commission (HPC) released a new DataPoints issue examining variation in imaging spending in Massachusetts and the U.S. for Medicare patients. This new research focuses on Medicare spending in Massachusetts for top imaging procedures for the first time and provides new insights into a critical, but potentially overused, aspect of patient care.

The HPC found significant annual spending differences for the average beneficiary among states. Among the key new findings, significant variation exists among states with regard to the frequency and volume of these services, with Massachusetts coming in as the 12^th highest utilizer of imaging services. This greater volume of imaging services, combined with the fact that more of these procedures are delivered in expensive facility locations in Massachusetts, such as hospital outpatient departments, contributes to the Commonwealth’s rank as the fourth highest spending state in this area.

As detailed in the HPC’s 2017 Cost Trends Report, Medicare prices in Massachusetts are typically more than twice as high when a service is provided in a hospital outpatient department as compared to an office setting. For example, the average price in Massachusetts for an MRI of the brain with contrast was more than twice as expensive at a facility setting ($699), compared to a non-facility setting ($337).

“Comparing the Commonwealth to the rest of the nation allows us to identify areas for improvement and take action to promote a more efficient, high-value delivery system that works for everybody,” said David Seltz, HPC Executive Director. “The analysis released today shows that the Commonwealth must continue to work to reduce the unnecessary utilization of facility-based care when the same service, in this case imaging procedures, can be provided in a lower-cost setting.”

Key Findings

• Overall, Original Medicare spending for imaging in Massachusetts totaled $762.1 million or 1.3 percent of total healthcare expenditures in 2015.
   
• Massachusetts spent $892 per beneficiary, 14 percent more than the rest of the United States, which spent $782 per beneficiary.
   
• Massachusetts spending was 21 percent higher in aggregate for the top imaging procedures than the United States. That percentage increased when examining specific subsets. For example, Massachusetts spent 31 percent more per beneficiary for advanced imaging, which includes magnetic resonance imaging (MRI) and computed tomography (CT) scans, than the U.S.
   
• The price of imaging services range from 3 percent to 20 percent higher in Massachusetts compared to the U.S. average. For example, the average price for one common imaging procedure (ultrasound of the heart) was $459 in Massachusetts, compared to an average U.S. price of $379, a 21 percent difference.
   
• Massachusetts ranked 12^th in utilization of imaging services among states, particularly high for electrocardiograms, which was 33 percent higher than the United States.

Today, the HPC also announced the release of a new report, Opportunities for Savings in Health Care 2018. This report will provide health care market participants, employers, policymakers, and the public with a greater understanding of the scope and scale of identified savings opportunities, based on the HPC’s policy recommendations to advance the goal of better health and better care at a lower cost.

Opportunities for Savings presents results from costs-savings modeling for seven scenarios, focusing on care that is unnecessary or has unnecessarily high costs. Potential savings from meeting the targets totals $4.76 billion, approximately 2.1 percent of total health care expenditures (THCE), if THCE continues to grow at a baseline trend of 3.55 percent every year. 

Download the full report here.

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