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Same-Day Sinus and Brain CT Imaging in the Medicare Population: Are Practice Patterns Changing in Association with Medicare Policy Initiatives?

Same-Day Sinus and Brain CT Imaging in the Medicare Population: Are Practice Patterns Changing in... BACKGROUND AND PURPOSE: Monitoring the frequency of same-day sinus and brain CT (Outpatient Measure 14, “OP-14”) is part of a recent large Centers for Medicare and Medicaid Services hospital outpatient quality initiative to improve imaging efficiency. This study investigates patient-level claims data in the Medicare population focusing on where same-day sinus and brain CT imaging is performed and how the frequency of same-day studies changed with time before and during OP-14 measure program implementation. MATERIALS AND METHODS: Research Identifiable Files were used to identify all sinus and brain CT examinations from 2004 through 2012 for a 5% random patient sample of Medicare fee-for-service beneficiaries. Overall and site of service use rates were calculated for same- and non-same-day examinations. Changes were mapped to policy initiative timetables. RESULTS: The number of same-day sinus and brain CT studies from 2004 to 2012 increased 67% from 1.85 (95% CI, 1.78–1.91) per 1000 Medicare beneficiaries in 2004 to 3.08 (95% CI, 3.00–3.15) in 2012. The biggest driver of increased same-day studies was the emergency department setting, from 0.56 (95% CI, 0.53–0.60) per 1000 to 1.78 (95% CI, 1.72–1.84; +215.7%). Overall use of brain CT from 146.0 (95% CI, 145.1–146.9) per 1000 to 176.3 (95% CI, 175.4–177.2; +21%) and sinus CT from 12.6 (95% CI, 12.4–12.8) per 1000 to 15.4 (95% CI, 15.2–15.6; +22%) increased until 2009 and remained stable through 2012. CONCLUSIONS: Previously increasing same-day sinus and brain CT in Medicare beneficiaries plateaued in 2009, coinciding with the implementation of targeted measures by the Centers for Medicare and Medicaid Services. Same-day imaging continues to increase in the emergency department setting. ABBREVIATIONS: CMS Centers for Medicare and Medicaid Services ED emergency department ICD-9 International Classification of Diseases, Ninth Revision OP-14 Outpatient Measure 14 (simultaneous use of brain CT and sinus CT) of the Hospital Outpatient Quality Reporting Program RIF Research Identifiable Files http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Same-Day Sinus and Brain CT Imaging in the Medicare Population: Are Practice Patterns Changing in Association with Medicare Policy Initiatives?

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2016 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A4670
pmid
26822731
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND AND PURPOSE: Monitoring the frequency of same-day sinus and brain CT (Outpatient Measure 14, “OP-14”) is part of a recent large Centers for Medicare and Medicaid Services hospital outpatient quality initiative to improve imaging efficiency. This study investigates patient-level claims data in the Medicare population focusing on where same-day sinus and brain CT imaging is performed and how the frequency of same-day studies changed with time before and during OP-14 measure program implementation. MATERIALS AND METHODS: Research Identifiable Files were used to identify all sinus and brain CT examinations from 2004 through 2012 for a 5% random patient sample of Medicare fee-for-service beneficiaries. Overall and site of service use rates were calculated for same- and non-same-day examinations. Changes were mapped to policy initiative timetables. RESULTS: The number of same-day sinus and brain CT studies from 2004 to 2012 increased 67% from 1.85 (95% CI, 1.78–1.91) per 1000 Medicare beneficiaries in 2004 to 3.08 (95% CI, 3.00–3.15) in 2012. The biggest driver of increased same-day studies was the emergency department setting, from 0.56 (95% CI, 0.53–0.60) per 1000 to 1.78 (95% CI, 1.72–1.84; +215.7%). Overall use of brain CT from 146.0 (95% CI, 145.1–146.9) per 1000 to 176.3 (95% CI, 175.4–177.2; +21%) and sinus CT from 12.6 (95% CI, 12.4–12.8) per 1000 to 15.4 (95% CI, 15.2–15.6; +22%) increased until 2009 and remained stable through 2012. CONCLUSIONS: Previously increasing same-day sinus and brain CT in Medicare beneficiaries plateaued in 2009, coinciding with the implementation of targeted measures by the Centers for Medicare and Medicaid Services. Same-day imaging continues to increase in the emergency department setting. ABBREVIATIONS: CMS Centers for Medicare and Medicaid Services ED emergency department ICD-9 International Classification of Diseases, Ninth Revision OP-14 Outpatient Measure 14 (simultaneous use of brain CT and sinus CT) of the Hospital Outpatient Quality Reporting Program RIF Research Identifiable Files

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Jun 1, 2016

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