Docs under threat of reimbursement cuts curb inappropriate imaging

A quality improvement effort that combines physician education with reimbursement dollars successfully curbed the practice of ordering inappropriate imaging tests, according to a study published this week in the Journal of the American College of Cardiology. The study, led by Kavitha Chinnaiyan, M.D., director of Advanced Cardiac Imaging Education at Royal Oak, Mich.-based Beaumont Health System, found that such measures reduced inappropriate coronary CT angiography (CCTA) orders by more than 60 percent.

The study compared the practice patterns of roughly 5,000 doctors across 47 medical facilities in Michigan and involved more than 25,000 patients enrolled in the Advanced Cardiovascular Imaging Consortium (ACIC). Blue Cross Blue Shield and Blue Care Network of Michigan, which sponsored ACIC, threatened to pull coverage if inappropriate use of medical imaging tests didn't change.

"This whole thing is a very collaborative effort between the payer and the physicians," Chinnaiyan told heartwire. "[The payers] were saying, 'We want you to make the right decision.' They didn't set specific parameters and say, 'You must do this,' but they said, 'We'd like to see a change because we can't sustain funding inappropriate studies.'"

In addition to the mammoth reduction in inappropriate imaging tests ordered, researchers also found a 23 percent increase in what were considered appropriate imaging tests. What's more, tests classified as "uncertain" decreased by close to 41 percent.

The researchers said the results had implications beyond statewide efforts.

"Although the ACIC is a complex undertaking requiring resource organization at every level of the process [referral, scheduling, point-of-care and follow-up], such collaborative partnerships between payers and physicians could result in similar successes on larger scales," they wrote.

To learn more:
- here's the study
- read this heartwire article (registration required)


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