Office-Based Diagnostic Imaging Interpreted by Nonphysician Practitioners: Characteristics, Recent Trends, and State...

Area of Science:

• Medical Imaging
• Healthcare Policy
• Health Services Research

Background:

• Nonphysician practitioners (NPPs), including nurse practitioners and physician assistants, are increasingly involved in patient care.
• Diagnostic imaging interpretation is a critical component of medical diagnosis, traditionally performed by radiologists.

Purpose of the Study:

• To analyze the trends and patterns of office-based diagnostic imaging interpretations performed by NPPs in the Medicare population.
• To investigate the association between NPP characteristics, employer specialty, and the volume of imaging interpretations.

Main Methods:

• A retrospective analysis of Medicare claims and provider datasets from 2013 to 2022.
• Identification of imaging interpretation claims submitted by NPPs in office settings.
• Mapping of NPPs to their physician employer specialties and assessment of practice patterns.

Main Results:

• Office-based imaging interpretations by NPPs increased by 9.0% annually, reaching 5.47% in 2022.
• Radiography, ultrasound, CT, MR, and nuclear medicine showed annual increases in NPP interpretations.
• NPPs employed by primary care physicians (39.5%) and orthopedists (34.1%) interpreted the largest shares of NPP imaging.
• Younger (<35 years) and male NPPs interpreted imaging more frequently than older and female counterparts, respectively.
• Significant geographic variation in interpretation shares was observed across states.

Conclusions:

• The proportion of office-based imaging interpretations by NPPs is growing within the Medicare system.
• A small subset of NPPs, characterized by younger age, male gender, and employment in primary care or orthopedic settings, performs the majority of these interpretations.
• Considerable state-level variations in NPP interpretation prevalence highlight the need for further investigation into regional practice differences.