4683. Analysis of Imaging Utilization in the Urgent Care Setting Among US Medicare Patients: 2013-2020
Authors * Denotes Presenting Author
  1. Aditya Khurana *; Mayo Clinic - Rochester
  2. Tariq Rashid; No Affiliation
  3. Richard Sharpe; Mayo Clinic - Phoenix
Urgent care facilities aim to provide speedy access to nonemergent healthcare services. The purpose of this study is to quantify recent trends in urgent care visits overall, by provider type, overall imaging utilization, and evaluate the impact of COVID-19 pandemic.

Materials and Methods:
The CMS Physician/Supplier Public Summary File was used to extract all records from urgent care facilities (place of service code 20) from 2013 to 2020. The number of urgent care visits each year was calculated by totaling the number of evaluation/management codes. All imaging services performed in an urgent care location were further analyzed. Using the Neiman Imaging Types of Service (NIOTOS) classification system, all imaging-related codes that included the professional component were then further extracted from this list of claims. NITOS allows imaging CPT codes to be further stratified by modality, including CT, MRI, ultrasound, radiography, and fluoroscopy. The utilization rate of imaging services overall and by imaging modality were calculated by dividing imaging volume by the number of urgent care visits in each year. Compound annual growth rates (CAGR) were calculated.

Urgent care visit overall volume was 2,028,899 in 2013 and 4,247,223 in 2019 (CAGR 13.1%). Total imaging volume in urgent care facilities was 227,219 in 2013 and 572,452 in 2019 (CAGR 16.7%). The utilization rate of imaging examinations per 10,000 urgent care visits was 1119.91 in 2013 and 1347.83 in 2019 (CAGR 3.14%). In 2020, urgent care visit overall volume was 4,406,417 (CAGR: 3.8%), total imaging volume was 395,486 (CAGR: - 30.9%), and the utilization rate of advanced imaging examinations per 10,000 urgent care visits was 897.52 in 2020 (CAGR: - 33.4%).

Significant increases in urgent care visits have occurred in recent years, with a corresponding slightly larger rate of growth in overall urgent care imaging volume. These findings suggest the radiologist workforce should ensure appropriate education and workflows to staff the increasing fraction of imaging volume that occurs in the urgent care setting, which likely expects speedy interpretations. The onset of the COVID-19 resulted in a mild increase in urgent care visits and dramatic decreases in imaging volume and imaging utilization rate, possibly reflecting a shift of urgent care facilities focusing resources on patients with COVID-19.