The Majority of Breast Imaging Services for US Medicare Beneficiaries Are Now Provided by Subspecialized Breast
Tariq Rashid1, Aditya Khurana2, Alan Zhu3
1Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, North Carolina.
Purpose:
The aim of this study was to evaluate breast imaging (BI) productivity trends in the US Medicare population from 2013 to 2022, including subspecialized interpretation trends overall, and by imaging modality.
Methods:
Outpatient imaging claims for the US Medicare population from 2013 to 2022 were extracted from CMS databases, categorized as BI or not and by imaging modality. Total work relative value units (wRVUs) and wRVUs for BI studies were summed, and year-specific BI case mixes were calculated per radiologist. Radiologists interpreting more than 50% of their case mix as BI each year were classified as subspecialized breast radiologists. Productivity and subspecialization trends overall and by imaging modality were evaluated.
Results:
From 2013 to 2022, BI wRVUs increased by 7.8% annually, and radiologists performing BI services decreased by 2.2% annually. The percentage of all radiologists submitting BI claims decreased from 46.5% to 34.2%. The number of subspecialized breast radiologists submitting claims for BI services increased by 7.1% annually. The percentage of all radiologists who were breast subspecialized increased from 8.1% in 2013 to 13.4% in 2022. BI wRVUs by subspecialized breast radiologists increased by 15.1% annually. Beginning in 2017, more BI wRVUs were performed by subspecialized breast radiologists than by <50% BI mix radiologists. The fraction of 2022 BI services provided by subspecialized breast radiologists varied by imaging modality: 63.7% for mammography, 70.0% for ultrasound, 80.5% for MRI, and 83.0% for interventional procedures.
Conclusions:
The majority of BI examinations for US Medicare beneficiaries are now interpreted by subspecialized breast radiologists, potentially advancing quality of care and informing education, workforce, and access considerations.
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