December 27, 2017
Double Scan CT Rates QPP Measurement Opportunity
A new research study by the Harvey L. Neiman Health Policy Institute explores the radiologist characteristics associated with variation in performance for two radiology-relevant hospital Outpatient Quality Reporting (OQR) measures: abdomen and chest CT “double scan” rates and makes recommendations to CMS for these measures. The study is published online in the Journal of the American College of Radiology (JACR).
“CMS did not exercise its authority to adopt hospital outpatient measures for certain specialties including radiologists,” stated Andrew Rosenkrantz, MD, MPA, lead study author and a Neiman Institute affiliate research fellow. “We have recommended that CMS expand its options for facility-based physicians in future years by adopting the Hospital OQR measures, which include double scan rates.”
The researchers used radiologists’ claims for abdomen and chest CT examinations in a facility setting using 2014 Medicare Physician and Other Supplier data. Individual radiologist double scan rates were computed. Associations were explored between rates and radiologist characteristics which were extracted from the CMS public data sets. Lower rates are typically considered to represent better, more efficient performance given the associated reduction in patient radiation exposure as well as in medical spending.
Among Medicare-participating radiologists nationally, the double scan rate averaged 5.9% ± 10.0% for abdomen CT and 1.0% ± 4.7% for chest CT. The greater differentiation in rates for abdomen, compared with the ubiquitously excellent performance for chest, supports a larger role for abdomen double scan rates in indicating disparities in radiologist performance.
“If CMS were indeed to incorporate these measures, then our data could help guide establishment of initial benchmarks,” said Richard Duszak, MD, FACR, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University and affiliate senior research fellow at the Harvey L. Neiman Health Policy Institute. “We envision that double scan rates would most likely be applied as part of an expanded array of facility-based measures.”
Setting standards in this fashion would be particularly useful given that benchmarks for these measures have not previously been established by the Hospital OQR program.
To obtain a copy of the JACR study or to arrange an interview with a Neiman Institute spokesperson, contact Nichole Gay at (703) 648-1665 or ngay@neimanhpi.org.
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About the Harvey L. Neiman Health Policy Institute
The Harvey L. Neiman Health Policy Institute is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care. Visit us at www.neimanhpi.org and follow us on Twitter, LinkedIn and Facebook.