Assesses adults 18–50 with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI or CT scan) within 28 days of the diagnosis (a higher score indicates better performance).
Why It Matters
Approximately 2.5 million Americans visit outpatient clinical settings for low back pain each year. Approximately 75% of adults will experience low back pain at some time in their lives. In any three-month period, approximately 25% of Americans will experience at least one day of back pain.
Evidence shows that unnecessary or routine imaging (X-ray, MRI, CT scans) for low back pain is not associated with improved outcomes. It also exposes patients to unnecessary harms such as radiation and further unnecessary treatment. For the majority of individuals who experience severe low back pain, pain improves within the first two weeks of onset.
Avoiding imaging for patients when there is no indication of an underlying condition can prevent unnecessary harm and unintended consequences to patients and can reduce health care costs.
Results – National Averages
Imaging Studies for Low Back Pain
| Measure Year | Commercial HMO | Commerial PPO | Medicaid HMO |
|---|---|---|---|
| 2021 | 78.4 | 76.6 | 74.5 |
| 2020 | 79.6 | 77.3 | 75.6 |
| 2019 | 78.1 | 76.2 | 74.7 |
| 2018 | 76.3 | 75.8 | 71.7 |
| 2017 | 76.1 | 75.7 | 71.7 |
| 2016 | 73.8 | 74.3 | 70.5 |
| 2015 | 75.4 | 74.9 | 73.6 |
| 2014 | 75.4 | 74.9 | 75.1 |
| 2013 | 75.2 | 74.5 | 75.5 |
| 2012 | 75.3 | 74.2 | 75.6 |
| 2011 | 74.4 | 73.7 | 75.8 |
| 2010 | 74.2 | 73.3 | 75.5 |
| 2009 | 73.9 | 72.7 | 76.1 |
| 2008 | 73.1 | 72.3 | 75.7 |
| 2007 | 74.6 | 73.3 | 77.3 |
| 2006 | 73.9 | 72.1 | 78.3 |
| 2005 | 75.4 | 72.6 | 79.0 |
This State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.
Figures do not account for changes in the underlying measure that could break trending. Contact Information Products via my.ncqa.org for analysis that accounts for trend breaks.