Spine-Related Conditions in MEPS 2020: Association Between Care Fragmentation and Outpatient MRI/CT Use and Radiology Expenditures

Outpatient advanced imaging is central to the evaluation of spine-related conditions, yet concerns persist about coordination and potential overuse. We assessed whether higher care fragmentation is associated with increased MRI/CT use and radiology expenditures among U.S. adults with spine-related conditions using 2020 Medical Expenditure Panel Survey (MEPS) data. A spine cohort was identified from ICD-10-CM and CCSR codes; care fragmentation was categorized using fixed cutpoints on full-year utilization. Outcomes included MRI/CT-only imaging in office-based care and radiology expenditures analyzed with survey-weighted regression models. Compared with Low fragmentation, Medium and High fragmentation were associated with higher odds of advanced imaging and higher odds of any radiology spending; conditional spending was directionally higher for High vs Low but imprecise. Effects appeared strongest among privately insured. Findings suggest opportunities to improve coordination and value in ambulatory spine care.