Medicare Beneficiaries Receive Imaging for LBP

One in Three Medicare Beneficiaries Receives Imaging for LBP Outside of Guidelines, Says HSC

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ORIGINAL ARTICLE

Jun 12, 2009 8:45 AM - Although rapid X-rays or other imaging for uncomplicated low back pain (LBP) are rarely indicated, almost 1 in 3 elderly Medicare patients received imaging services within a month of LBP diagnosis, say researchers at the Center for Studying Health System Change (HSC) based on their study published in the May 25 Archives of Internal Medicine.

Well-established guidelines suggest that patients with LBP do not require imaging until after a month of conservative therapy, such as physical therapy, in the absence of specific clinical "red flags" such as cancer, says HSC. Yet, 28.8% of elderly Medicare beneficiaries with LBP were imaged within 28 days of diagnosis, according to the study.

Among patients who received imaging, 88.2% had a plain X-ray, while 11.8% had a CT scan or MRI scan as their initial study. Nearly 1/3 of imaging studies were performed in the practice of the patient’s primary physician.

Caucasian patients were more likely to receive rapid imaging and CT/MRI than minority patients. Medicaid patients received fewer rapid or advanced imaging procedures than other patients. Similarly, patients treated in practices more reliant on Medicaid revenues received fewer rapid or advanced imaging procedures, according to HSC. Patients received higher levels of imaging if their primary care physician was exposed to satisfaction-based incentives or worked in large group practices.

Physical therapists are trained to look for 'red flags' during the evaluation process.

Call ECRC Physical Therapy if you are looking for treatment for LBP.