DXA Utilization Between 2006 and 2012 in Commercially Insured Younger Postmenopausal Women

Area of Science:

• Health Economics
• Medical Imaging
• Osteoporosis Management

Background:

• Reimbursement for dual-energy X-ray absorptiometry (DXA) scans has decreased since 2006.
• Previous research indicated a link between reduced DXA reimbursement and lower scan utilization.

Purpose of the Study:

• To update DXA utilization estimates through 2012 in commercially insured patients.
• To compare DXA scan rates before and after reimbursement changes.

Main Methods:

• Analysis of DXA utilization in women aged 50-64 using Marketscan Commercial Claims data (2006-2012).
• Estimation of utilization rates per 1000 person-years (PY).
• Segmented regression analysis to assess changes post-July 2009 reimbursement reduction.

Main Results:

• DXA utilization in 2006 was 144 scans per 1000 PY, peaking at 149 per 1000 PY in 2009.
• By 2012, utilization dropped to 110 scans per 1000 PY, a decrease of 37.5 scans per PY compared to 2006.
• A significant decline of 12.98 DXAs per 1000 persons was observed after July 2009.

Conclusions:

• A significant decrease in DXA utilization occurred in younger, postmenopausal, commercially insured women after July 2009.
• This decline aligns with Medicare reimbursement reductions for DXA scans.