Annual Medicare mammography spending jumped 50% with newer tech

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While Medicare’s mammography costs increased nearly 50 percent in the early 2000s, the number of women screened and detection rates for early-stage disease remained stable.

However, the spike in costs—a $300 million increase in annual spending from 2001 to 2009—did coincide with many providers’ transition from plain-film to digital mammography, according to a study published online July 1 in the Journal of the National Cancer Institute.

Study authors Cary Gross, MD, of Yale University, and colleagues studied the rise in costs by analyzing mammography utilization rates, cancer detection and spending among Medicare beneficiaries 66 years of age or older who received mammograms during two time periods: 2001-2002 and 2008-2009. The total study population included more than 270,000 patients.

Results showed annual Medicare spending on mammography increased from $666 million to $962 million between the two time periods, though use of screening mammography was roughly the same.

What did change, according to Gross and colleagues, was the use of digital mammography and computer-aided detection (CAD). Digital mammography use rose from 2 percent to nearly 30 percent over the study period, and CAD utilization rose from 3.2 percent to 33.1 percent.

As a result of the growing use of more expensive technology, the cost per screening increased from $75 to $101 during the study period.

For the patient population in this study, Medicare may not be getting the best bang for its buck with the use of newer, and more expensive, technology, as clinical trials have not shown digital mammography to be superior to plain-film for women 65 years of age or older. Gross and colleagues also noted that while the U.S. Preventive Services Task Force does not recommend breast cancer screening for women 75 years or older, Medicare spent an increasing amount on screening this population over the study period.