Conventional radiography, rapid MR imaging, and conventional MR imaging for low back pain

Activity-based costs and reimbursement

Darryl T. Gray, William Hollingworth, C. Craig Blackmore, Michael A. Alotis, Brook I. Martin, Sean D. Sullivan, Richard (Rick) Deyo, Jeffrey G. Jarvik

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

PURPOSE: To incorporate personnel and equipment use time in an activity-based cost comparison of conventional radiography and conventional and rapid magnetic resonance (MR) imaging for low back pain (LBP). MATERIALS AND METHODS: At each of four Seattle Lumbar Imaging Project (SLIP) sites, patients were randomized to undergo conventional radiography or rapid MR imaging of the lumbar spine. For sample SLIP patients and for similar non-SLIP patients undergoing conventional lumbar spine MR imaging as usual care in calendar year 2000, measured imaging room use and technologist and radiologist times were multiplied by costs per minute of standard equipment acquisition, personnel compensation, and related expenses. Resulting provider-perspective costs and Seattle area Medicare reimbursements for conventional MR imaging and radiography for calendar year 2001 were used to estimate future "normative" reimbursement for rapid MR imaging. RESULTS: For 23 conventional radiography, 27 rapid MR imaging, and 38 conventional MR imaging examinations timed in calendar year 2000, all rapid MR imaging times exceeded those of conventional radiography but were less than those of conventional MR imaging. All 0.3- and 0.35-T MR imaging room and technologist times exceeded those for 1.5-T MR imaging. Average costs (in 2001 dollars) were $44 for conventional radiography, $126 for 1.5-T rapid MR imaging, $128 for 0.3-0.35-T rapid MR imaging, $267 for 1.5-T conventional MR imaging, and $264 for 0.3-0.35-T conventional MR imaging. Conclusions regarding cost differences between conventional radiography and rapid MR imaging were robust to plausible parameter value changes evaluated in sensitivity analyses. Conventional radiography reimbursement was $44. Applying the ratio of reimbursement ($620) to costs ($264-$267) for conventional MR imaging to rapid MR imaging costs predicted reimbursement of $292-$300 for the new modality. CONCLUSION: Times and costs for rapid MR imaging are roughly three times those for conventional radiography but about half those for conventional MR imaging for LBP. While current conventional radiography costs exceed reimbursement, current conventional MR and projected rapid MR imaging reimbursements exceed costs.

Original languageEnglish (US)
Pages (from-to)669-680
Number of pages12
JournalRadiology
Volume227
Issue number3
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

Fingerprint

Low Back Pain
Radiography
Magnetic Resonance Imaging
Costs and Cost Analysis
Spine
Equipment and Supplies

Keywords

  • Cost effectiveness Economics
  • Medical Radiology and radiologists
  • MR
  • Radiography
  • Socioeconomic issues Spine
  • Spine

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Gray, D. T., Hollingworth, W., Blackmore, C. C., Alotis, M. A., Martin, B. I., Sullivan, S. D., ... Jarvik, J. G. (2003). Conventional radiography, rapid MR imaging, and conventional MR imaging for low back pain: Activity-based costs and reimbursement. Radiology, 227(3), 669-680. https://doi.org/10.1148/radiol.2273012213

Conventional radiography, rapid MR imaging, and conventional MR imaging for low back pain : Activity-based costs and reimbursement. / Gray, Darryl T.; Hollingworth, William; Blackmore, C. Craig; Alotis, Michael A.; Martin, Brook I.; Sullivan, Sean D.; Deyo, Richard (Rick); Jarvik, Jeffrey G.

In: Radiology, Vol. 227, No. 3, 01.06.2003, p. 669-680.

Research output: Contribution to journalArticle

Gray, DT, Hollingworth, W, Blackmore, CC, Alotis, MA, Martin, BI, Sullivan, SD, Deyo, RR & Jarvik, JG 2003, 'Conventional radiography, rapid MR imaging, and conventional MR imaging for low back pain: Activity-based costs and reimbursement', Radiology, vol. 227, no. 3, pp. 669-680. https://doi.org/10.1148/radiol.2273012213
Gray, Darryl T. ; Hollingworth, William ; Blackmore, C. Craig ; Alotis, Michael A. ; Martin, Brook I. ; Sullivan, Sean D. ; Deyo, Richard (Rick) ; Jarvik, Jeffrey G. / Conventional radiography, rapid MR imaging, and conventional MR imaging for low back pain : Activity-based costs and reimbursement. In: Radiology. 2003 ; Vol. 227, No. 3. pp. 669-680.
@article{cb2899ff32004a65949d43b1c72515aa,
title = "Conventional radiography, rapid MR imaging, and conventional MR imaging for low back pain: Activity-based costs and reimbursement",
abstract = "PURPOSE: To incorporate personnel and equipment use time in an activity-based cost comparison of conventional radiography and conventional and rapid magnetic resonance (MR) imaging for low back pain (LBP). MATERIALS AND METHODS: At each of four Seattle Lumbar Imaging Project (SLIP) sites, patients were randomized to undergo conventional radiography or rapid MR imaging of the lumbar spine. For sample SLIP patients and for similar non-SLIP patients undergoing conventional lumbar spine MR imaging as usual care in calendar year 2000, measured imaging room use and technologist and radiologist times were multiplied by costs per minute of standard equipment acquisition, personnel compensation, and related expenses. Resulting provider-perspective costs and Seattle area Medicare reimbursements for conventional MR imaging and radiography for calendar year 2001 were used to estimate future {"}normative{"} reimbursement for rapid MR imaging. RESULTS: For 23 conventional radiography, 27 rapid MR imaging, and 38 conventional MR imaging examinations timed in calendar year 2000, all rapid MR imaging times exceeded those of conventional radiography but were less than those of conventional MR imaging. All 0.3- and 0.35-T MR imaging room and technologist times exceeded those for 1.5-T MR imaging. Average costs (in 2001 dollars) were $44 for conventional radiography, $126 for 1.5-T rapid MR imaging, $128 for 0.3-0.35-T rapid MR imaging, $267 for 1.5-T conventional MR imaging, and $264 for 0.3-0.35-T conventional MR imaging. Conclusions regarding cost differences between conventional radiography and rapid MR imaging were robust to plausible parameter value changes evaluated in sensitivity analyses. Conventional radiography reimbursement was $44. Applying the ratio of reimbursement ($620) to costs ($264-$267) for conventional MR imaging to rapid MR imaging costs predicted reimbursement of $292-$300 for the new modality. CONCLUSION: Times and costs for rapid MR imaging are roughly three times those for conventional radiography but about half those for conventional MR imaging for LBP. While current conventional radiography costs exceed reimbursement, current conventional MR and projected rapid MR imaging reimbursements exceed costs.",
keywords = "Cost effectiveness Economics, Medical Radiology and radiologists, MR, Radiography, Socioeconomic issues Spine, Spine",
author = "Gray, {Darryl T.} and William Hollingworth and Blackmore, {C. Craig} and Alotis, {Michael A.} and Martin, {Brook I.} and Sullivan, {Sean D.} and Deyo, {Richard (Rick)} and Jarvik, {Jeffrey G.}",
year = "2003",
month = "6",
day = "1",
doi = "10.1148/radiol.2273012213",
language = "English (US)",
volume = "227",
pages = "669--680",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "3",

}

TY - JOUR

T1 - Conventional radiography, rapid MR imaging, and conventional MR imaging for low back pain

T2 - Activity-based costs and reimbursement

AU - Gray, Darryl T.

AU - Hollingworth, William

AU - Blackmore, C. Craig

AU - Alotis, Michael A.

AU - Martin, Brook I.

AU - Sullivan, Sean D.

AU - Deyo, Richard (Rick)

AU - Jarvik, Jeffrey G.

PY - 2003/6/1

Y1 - 2003/6/1

N2 - PURPOSE: To incorporate personnel and equipment use time in an activity-based cost comparison of conventional radiography and conventional and rapid magnetic resonance (MR) imaging for low back pain (LBP). MATERIALS AND METHODS: At each of four Seattle Lumbar Imaging Project (SLIP) sites, patients were randomized to undergo conventional radiography or rapid MR imaging of the lumbar spine. For sample SLIP patients and for similar non-SLIP patients undergoing conventional lumbar spine MR imaging as usual care in calendar year 2000, measured imaging room use and technologist and radiologist times were multiplied by costs per minute of standard equipment acquisition, personnel compensation, and related expenses. Resulting provider-perspective costs and Seattle area Medicare reimbursements for conventional MR imaging and radiography for calendar year 2001 were used to estimate future "normative" reimbursement for rapid MR imaging. RESULTS: For 23 conventional radiography, 27 rapid MR imaging, and 38 conventional MR imaging examinations timed in calendar year 2000, all rapid MR imaging times exceeded those of conventional radiography but were less than those of conventional MR imaging. All 0.3- and 0.35-T MR imaging room and technologist times exceeded those for 1.5-T MR imaging. Average costs (in 2001 dollars) were $44 for conventional radiography, $126 for 1.5-T rapid MR imaging, $128 for 0.3-0.35-T rapid MR imaging, $267 for 1.5-T conventional MR imaging, and $264 for 0.3-0.35-T conventional MR imaging. Conclusions regarding cost differences between conventional radiography and rapid MR imaging were robust to plausible parameter value changes evaluated in sensitivity analyses. Conventional radiography reimbursement was $44. Applying the ratio of reimbursement ($620) to costs ($264-$267) for conventional MR imaging to rapid MR imaging costs predicted reimbursement of $292-$300 for the new modality. CONCLUSION: Times and costs for rapid MR imaging are roughly three times those for conventional radiography but about half those for conventional MR imaging for LBP. While current conventional radiography costs exceed reimbursement, current conventional MR and projected rapid MR imaging reimbursements exceed costs.

AB - PURPOSE: To incorporate personnel and equipment use time in an activity-based cost comparison of conventional radiography and conventional and rapid magnetic resonance (MR) imaging for low back pain (LBP). MATERIALS AND METHODS: At each of four Seattle Lumbar Imaging Project (SLIP) sites, patients were randomized to undergo conventional radiography or rapid MR imaging of the lumbar spine. For sample SLIP patients and for similar non-SLIP patients undergoing conventional lumbar spine MR imaging as usual care in calendar year 2000, measured imaging room use and technologist and radiologist times were multiplied by costs per minute of standard equipment acquisition, personnel compensation, and related expenses. Resulting provider-perspective costs and Seattle area Medicare reimbursements for conventional MR imaging and radiography for calendar year 2001 were used to estimate future "normative" reimbursement for rapid MR imaging. RESULTS: For 23 conventional radiography, 27 rapid MR imaging, and 38 conventional MR imaging examinations timed in calendar year 2000, all rapid MR imaging times exceeded those of conventional radiography but were less than those of conventional MR imaging. All 0.3- and 0.35-T MR imaging room and technologist times exceeded those for 1.5-T MR imaging. Average costs (in 2001 dollars) were $44 for conventional radiography, $126 for 1.5-T rapid MR imaging, $128 for 0.3-0.35-T rapid MR imaging, $267 for 1.5-T conventional MR imaging, and $264 for 0.3-0.35-T conventional MR imaging. Conclusions regarding cost differences between conventional radiography and rapid MR imaging were robust to plausible parameter value changes evaluated in sensitivity analyses. Conventional radiography reimbursement was $44. Applying the ratio of reimbursement ($620) to costs ($264-$267) for conventional MR imaging to rapid MR imaging costs predicted reimbursement of $292-$300 for the new modality. CONCLUSION: Times and costs for rapid MR imaging are roughly three times those for conventional radiography but about half those for conventional MR imaging for LBP. While current conventional radiography costs exceed reimbursement, current conventional MR and projected rapid MR imaging reimbursements exceed costs.

KW - Cost effectiveness Economics

KW - Medical Radiology and radiologists

KW - MR

KW - Radiography

KW - Socioeconomic issues Spine

KW - Spine

UR - http://www.scopus.com/inward/record.url?scp=0037950464&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037950464&partnerID=8YFLogxK

U2 - 10.1148/radiol.2273012213

DO - 10.1148/radiol.2273012213

M3 - Article

VL - 227

SP - 669

EP - 680

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 3

ER -