G2TT
来源类型Report
规范类型报告
来源IDRR-706-CMS
Medicare Imaging Demonstration Final Evaluation: Report to Congress
Justin W. Timbie; Peter S. Hussey; Lane F. Burgette; Neil S. Wenger; Afshin Rastegar; Ian Brantley; Dmitry Khodyakov; Kristin J. Leuschner; Beverly A. Weidmer; Katherine L. Kahn
发表日期2014-11-10
出版年2014
页码202
语种英语
结论 Medicare Imaging Demonstration Final Evaluation: Report to Congress | RAND
摘要

Increasing use of advanced medical imaging is often cited as a key driver of cost growth in medical spending. In 2011, the Medicare Imaging Demonstration from the Centers for Medicare & Medicaid Services began testing whether exposing ordering clinicians to appropriateness guidelines for advanced imaging would reduce ordering inappropriate images. The evaluation examined trends in advanced diagnostic imaging utilization starting January 1, 2009 — more than two years before the beginning of the demonstration — to November 30, 2013 — two months after the close of the demonstration. Small changes in ordering patterns were noted, but decision support systems were unable to assign appropriateness ratings to many orders, thus limiting the potential effectiveness of decision support. Many opportunities to refine decision support systems have been identified.

目录
  • Section I

    Report Overview

    • Chapter One

      Background and Description of the Demonstration and Its Evaluation

  • Section II

    Convener-Level Results Associated with Advanced Image Ordering with Decision Support Systems for Practices Associated with the Medicare Imaging Demonstration

    • Chapter Two

      Analysis of DSS Data

    • Chapter Three

      Analysis of the Impact of the MID Demonstration on the Appropriateness of Advanced Imaging Orders

    • Chapter Four

      Relationships Between the Appropriateness of Advanced Imaging Procedure Orders and Imaging Results

  • Section III

    Convener-Level Analyses of Advanced Image Utilization Before and After the Medicare Imaging Demonstration Was Introduced in Practices Associated with the Demonstration Compared with Comparable Control Practices

    • Chapter Five

      Trends in Imaging Utilization in the Medicare Imaging Demonstration

  • Section IV

    Physician and Patient Experience with Appropriateness Criteria for Advanced Imaging

    • Chapter Six

      Physician Satisfaction with Exposure to Advanced Imaging Appropriateness Criteria in the Demonstration

    • Chapter Seven

      Medicare Patient Satisfaction in the Demonstration with Receiving an Advanced Imaging Procedure after Physicians Were Exposed to Appropriateness Criteria

  • Section V

    Six Statute Questions That Can Inform Future Recommendations About Decision Support

    • Chapter Eight

      Recommendations About the Acceptability of MID's DSS for Identifying Appropriate Versus Inappropriate Advanced Imaging Orders

    • Chapter Nine

      Recommendations About Volume of Utilization in Response to Physician Exposure to Advanced Imaging Appropriateness Criteria at the Time of Orders

    • Chapter Ten

      Recommendations About the Advisability of Expanding the Use of Appropriateness Criteria for Ordering Advancing Imaging to a Broader Population of Medicare Beneficiaries

    • Chapter Eleven

      Recommendations About the Advisability of Allowing High-Performing Physicians to Be Exempt from Requirements to Consult Appropriateness Criteria

    • Chapter Twelve

      Recommendations About the Value of Live Feedback on the Appropriateness of Advanced Imaging Orders from a Decision Support System Compared with Feedback Reports to Individual Physicians or Physician Practices

    • Chapter Thirteen

      Recommendations About Strategies for Motivating Physicians to Comply with Ordering Advanced Imaging Appropriately According to Appropriateness Criteria

  • Section VI

    Conclusion

    • Chapter Fourteen

      Conclusions

  • Technical Appendix A

    DSS and Claims Methods

  • Technical Appendix B

    Evaluation of the MID: Focus Group Methodology

主题Cost-Effectiveness in Health Care ; Health Care Quality Measurement ; Health Care Technology ; Measuring Health Care Costs ; Medicare ; Patient Experience
URLhttps://www.rand.org/pubs/research_reports/RR706.html
来源智库RAND Corporation (United States)
资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/522605
推荐引用方式
GB/T 7714
Justin W. Timbie,Peter S. Hussey,Lane F. Burgette,et al. Medicare Imaging Demonstration Final Evaluation: Report to Congress. 2014.
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