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8 0 Fied Scanners 1 Fied Scanner 2-4 Fied Scanners 5-7 Fied Scanners Service Area Bundaries - Fied Site - Mbile Site

9 # MRI Scanners , , , ,000 # MRI Prcedures Fied MRI Scanners Ttal MRI Prcedures

10 Ppulatin per MRI Scanner 20,000 40,000 60,000 80, , Nrth Carlina United States MRI Prcecures per 1, Nrth Carlina United States

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12 # Apprved Fied Scanners ,000 10,000 15,000 20,000 # MRI Prcedures Pre-2005 Rule Pst-2005 Rule

13 0 Fied Scanners 1 Fied Scanner 2-4 Fied Scanners 5-7 Fied Scanners 8+ Fied Scanners Service Area Bundaries - Fied Site - Mbile Site

14 # Apprvals

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18 MRI Prcedures 200, , , , Medicare Ttal

19 Prcedure Cunt 0 1,000,000 2,000,000 3,000,000 XRAY ULTRA CT ECHO MRI

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22 Cumulative Prcedure Cunt Mnths Since Initial Back Pain XRAY CT ECHO ULTRA MRI

23 Cumulative Medical Csts ($) 0 5,000 10,000 15,000 20,000 25,000 TOTAL OOP Mnths Since Initial Back Pain

24 Cumulative Back Pain Claims Mnths Since Initial Back Pain

25 p j j a j 1 ( ) p j p j p j y j y j = γ + θa j + u j θ u j a j u j a j θ y j = γ + θa j + β 0 p j + β 1 a j p j + u j p j y j p j y j

26 t y jt = θ τ a j,t τ + u jt τ=0 θ τ = y jt / a j,t τ j t τ a j,t τ t y jt θ P τ dy jt da j,t τ = y jt a j,t τ + = θ τ + τ θ τ h π h h=1 τ h=1 ( yjt da ) j,t τ+h a j,t τ+h da j,t τ π h da j,t τ+h /da j,t τ h π 1 < 0

27 t y j,t+τ = θ P τ a jt + β 0 p jt + β 1 a jt p jt + u j,t+τ t τ θ P τ u j,t+τ a jt u j,t+τ τ [ 2, 4] 4 ( y jtτ = θ P τ a jt + βτ 0 p jt + βτ 1 ) a jt p jt + δτ + λ jt + e jtτ τ= 2 j t τ λ jt δ τ θτ P βτ 0 βτ 1 τ = 0 θ P τ τ

28 (j, t) i d y i,d,j,t+τ j, t τ τ = 2 τ t ±350

29 Frequency Nrmalized Prcedures p j a j

30

31 Years frm Apprval -1

32 τ τ τ τ τ τ

33

34 Years frm Apprval

35 Years frm Apprval

36

37 τ τ τ τ τ τ

38 10,000 8,000 6,000 4,000 2,000-2, Years frm Apprval -4,000 3,000 2,000 1,000-1, ,000-3,000-4,000 Years frm Apprval 10,000 8,000 6,000 4,000 2,000-2, ,000 Years frm Apprval -6,000

39

40

41 τ τ τ τ τ τ

42

43 -10,000-5, ,000 10, Years frm Apprval Years frm Apprval

44 τ τ τ τ τ τ

45 Years frm Apprval

46 τ τ τ τ τ τ

47 Years frm Apprval

48 τ τ τ τ τ τ

49 τ = 2

50 τ τ τ τ τ τ

51 -20,000-10, ,000 20, Years frm Apprval -100,000-50, , Years frm Apprval -20,000-10, ,000 20, Years frm Apprval

52 Cumulative MRI Prcedures Mnths Since Initial Back Pain τ = 2 d = 0, 1, 2,..., 12

53

54 Cumulative CT Prcedures Mnths Since Initial Back Pain τ = 2 d = 0, 1, 2,..., 12

55 Cumulative X-Ray Prcedures Mnths Since Initial Back Pain τ = 2 d = 0, 1, 2,..., 12

56

57 Cumulative Ttal Medical Csts -2,000-1, ,000 2,000 3, Mnths Since Initial Back Pain Cumulative Out f Pcket Csts -1, ,000 1, Mnths Since Initial Back Pain τ = 2 d = 0, 1, 2,..., 12

58 Cumulative Back Pain Claims Mnths Since Initial Back Pain τ = 2 d = 0, 1, 2,..., 12

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KBG Associates. Company Secretaries

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