Navigation Links
Medicare and Medicaid CT scan measure is unreliable according to new BWH study
Date:2/23/2012

BOSTON, MAResearchers at Brigham and Women's Hospital (BWH) have published findings that question the reliability of a new Centers for Medicare and Medicaid Services (CMS) quality measure. The study, "Assessment of Medicare's Imaging Efficiency Measure for Emergency Department Patients With Atraumatic Headache" finds that the CMS measurean attempt to reduce computed tomography (CT) scans in emergency departments (ED)does not accurately determine which hospitals are performing CT scans inappropriately.

The study is electronically published in the February 23, 2012 issue of Annals of Emergency Medicine.

With the recent surge of CT use in EDs, comes concern about radiation exposure and cost. CMS developed measure OP-15, "Use of Brain Computed Tomography in the Emergency Department for Atraumatic Headache," to evaluate the use of brain CT in the ED for atraumatic headache in order to improve imaging efficiency. The measure was implemented into the Outpatient Prospective Payment System in January 2012 but was never field-tested.

Jeremiah Schuur, MD, BWH Department of Emergency Medicine, and colleagues at 21 EDs in the United States studied the reliability, validity, and accuracy of measure OP-15. The measure uses Medicare billing records to determine whether a CT was clinically appropriate.

The researchers compared the data reliability of the measure as obtained from CMS administrative data against data from ED medical records. They reviewed 748 patient visits that CMS labeled as having undergone inappropriate brain CTs based on billing data. However, when the patients' medical records were reviewed, they showed that the bills didn't tell the whole story; the researchers discovered that 65 percent of the CT scans actually complied with Medicare's measure and another 18 percent of patients had valid reasons for the CTs documented on their charts. Overall, 83 percent of the patients should not have been labeled as having been inappropriately imaged.

This led researchers to conclude that CMS measure OP-15 may lead to inaccurate comparisons of EDs' imaging performance.

"It is important for physicians, hospitals and payers to work together to develop systems that ensure that every CT that is performed is appropriate," said Schuur. "Our research finds that OP-15 may not be a valid measure of imaging in elders and that when calculated from Medicare claims, can produce unreliable data."

"Further research should focus on developing scientific evidence that could be used to better inform this measure," added Ali Raja, MD, associate director for trauma, BWH Department of Emergency Medicine, and study co-author. According to Raja, "existing guidelines built around solid evidence for the appropriate use of CT for other clinical conditions could serve as a guide for the measurement of these and similar conditions."


'/>"/>

Contact: Marjorie Montemayor-Quellenberg
mmontemayor-quellenberg@partners.org
617-534-2208
Brigham and Women's Hospital
Source:Eurekalert

Related medicine news :

1. Colon Cancer Alliance and American College of Radiology demand Medicare cover virtual colonoscopy
2. Gym benefits help Medicare plans recruit healthy seniors
3. Covering Gym Fees Might Be Money Saver for Medicare
4. Research finds Medicare and private insurance spending similar throughout Texas
5. Congress disarray makes it likely that 27 percent Medicare cut will go in effect
6. Internists applaud Schwartz Proposal to prevent devastating Medicare cuts
7. Seniors Choose Medicare Prescription Plans Wisely: Study
8. Medicare Part B Premium Increase Lower Than Expected
9. Many Medicare Patients Get Surgeries in Last Year of Life: Study
10. Medicare patients at risk of long-term institutionalization after hospital stay
11. Enrollment Period for Medicare Starts Early This Year
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/23/2017)... ... ... The physicians of KSF Orthopaedic Center PA are proud to announce the opening ... at 2255 E. Mossy Oaks Rd., Suite 440, Spring, Texas 77389 inside the new ... in the north Houston area (The Woodlands, Conroe, Magnolia, Kingwood, Humble) with an even ...
(Date:3/23/2017)... ... March 23, 2017 , ... PAINWeekEnd ... at 10 North Broadway Avenue, will be an educational and exciting program providing ... in the management of chronic pain. , Oklahoma is in a healthcare crisis. ...
(Date:3/23/2017)... ... ... of adults are unaware of the dangers that infectious bacteria play in mouth disease, while ... a day that dentists recommend. The ramifications of improper oral upkeep go far beyond bad ... 164 million hours of work each year due to dental issues. That is why Mediaplanet ...
(Date:3/23/2017)... ... March 23, 2017 , ... Benefits delivery trailblazer, ... mobile app and centralized benefits dashboard solving one of the top frustrations in ... locations. For the first time, employees can access up-to-date information and account balances ...
(Date:3/23/2017)... Malvern, PA (PRWEB) , ... March 23, 2017 ... ... a comprehensive educational training program owned and organized by HMP Communications Holdings, LLC, ... training program for physicians within its nationwide network of wound centers interested in ...
Breaking Medicine News(10 mins):
(Date:3/23/2017)... The key factors driving the growth of dialysis ... growth and increasing healthcare expenditure. Some of the noteworthy trends ... ESRD patients, rising demand for home PD treatment and huge ... market is hindered by high treatment costs and stringent regulations. ... Complete ...
(Date:3/23/2017)... March 23, 2017  Transportation Insight, a multi-modal lead ... supply chain management firm with expertise serving clients in ... Rick Zaffarano was named a 2017 ... Chain by the only publication exclusively dedicated to covering ... chain. "Rick has brought to Transportation Insight ...
(Date:3/23/2017)... INDIANAPOLIS , March 23, 2017  Eli ... the William Sansum Diabetes Center have established a research ... by diabetes through enhanced research, education and care. ... disease bears a disproportionate weight on Latino families in ... David Kerr , M.D., FRCPE, director of Innovation and ...
Breaking Medicine Technology: