Clinical Decision Support: Impact on Appropriate Imaging Utilization.

The modern era has seen significant growth in the use of advanced imaging. During the early 2000s, use of advanced imaging in the United States rose to historic highs ( 1 Hirsch JA Harvey HB Barr RM et al. Sustainable growth rate repealed, MACRA revealed: historical context and analysis of recent changes in medicare physician payment methodologies. AJNR Am J Neuroradiol. 2016; 37: 210-214 Crossref PubMed Scopus (43) Google Scholar , 2 Lee DW Duszak R Hughes DR Comparative analysis of Medicare spending for medical imaging: sustained dramatic slowdown compared with other services. AJR Am J Roentgenol. 2013; 201: 1277-1282 Crossref PubMed Scopus (46) Google Scholar , 3 Hong AS Levin D Parker L et al. Trends in diagnostic imaging utilization among Medicare and commercially insured adults from 2003 through 2016. Radiology. 2020; 294: 342-350 Crossref PubMed Scopus (24) Google Scholar , 4 Papanicolas I Woskie LR Jha AK. Health care spending in the United States and other high-income countries. Jama. 2018; 319: 1024-1039 Crossref PubMed Scopus (836) Google Scholar ). For example, imaging expenditure per Medicare beneficiary increased 85%, outstripping a 34% relative growth in fees for evaluation and management between 2000 and 2009. Factors contributing to the increased use of imaging include advances in technology, expanded clinical indications, an aging population, and increased availability.