More office-based APPs are interpreting images: Study

Imaging interpretation by non-physician practitioners in office-based practices increased 9% annually between 2013 and 2022, according to a study published Nov. 20 in the Journal of the American College of Radiology.

The increase reflects a total 117% increase over the study period, according to a Nov. 19 news release from Reston, Va.-based Harvey L. Neiman Health Policy Institute. 

Researchers from the institute and Jackson-based University of Mississippi Medical Center analyzed Medicare claims and provider datasets for imaging interpretation claims submitted by nurse practitioners and physician assistants for the study.

Here are five things to know:

1. The increase of non-physician practitioners imaging interpretation claims was seen across all modalities: radiography (8.9%), ultrasound (9.4%), CT scans (9.4%), magnetic resonance (9.9%) and nuclear medicine (7.2%).
   
   
2. Only 5.55% of non-physician practitioners reported imaging interpretations, though rates varied across states from 13.16% in Alaska to 0.29% in Washington, D.C.
   
   
3. Non-physician practitioners employed by primary care physicians had the largest share of image interpretation at 39.5% followed by non-physician practitioners employed by orthopedists at 34.1%.
   
   
4. By modality, imaging interpretation claims were highest among non-physician practitioners employed by:
   
   
   • Primary care physicians (39.7%) and orthopedists (37.4%) for radiography
     
     
   • Primary care physicians (44.7%) and practices without physicians (12.7%) for ultrasound
     
     
   • Primary care physicians (58.2%) and otolaryngologists (17.1%) for CT scans
     
     
   • Orthopedists (60.3%) and primary care physicians (24%) for magnetic resonance
     
     
   • Primary care physicians (40.4%) and cardiologists (25.9%) for nuclear medicine
     
     
5. Male non-physician practitioners were 61% more likely to interpret imaging compared to female non-physician practitioners, and non-physician practitioners younger than 35 were 41-43% more likely to interpret imaging compared to NPPs 65 years or older.

"With new NPPs entering the workforce at an increasing pace, this age discrepancy suggests that the growth of NPP imaging interpretation could further accelerate," Richard Duszak, MD, professor and chair in the department of radiology at the University of Mississippi Medical Center said in the news release. "[This draws] additional attention to considerable mismatches in education and training for imaging interpretation when compared with radiologists."