A study in the Annals of Emergency Medicine concludes that a new imaging efficiency measure from the CMS known as OP-15 is not accurate in determining which hospitals perform CT scans under appropriate circumstances.
Study calls CMS' CT scan measure inaccurate
The measure uses Medicare billing records to determine whether a CT was clinically appropriate. But when researchers examined patients' medical records for CT brain scans, they concluded that 65% of the CT scans actually complied with Medicare's measure, while another 18% of patients had legitimate reasons for the CT scans that were documented on their charts. Researchers at 21 hospitals examined medical records for 748 headache patients whom CMS determined had undergone an inappropriate CT brain scan.
“The measure, OP-15, was only 17% accurate in assessing which patients should receive a CT scan,” Dr. Jeremiah Schuur, the study's lead author, said in an e-mailed news release. Schuur works in the emergency department at Brigham and Women's Hospital in Boston and is an assistant professor at Harvard Medical School. “Furthermore, hospitals' performance on the new measure as reported by CMS did not match the proportion of CTs with a documented clinical indication,” he said. “By using it, Medicare runs the risk of publicizing inaccurate information about clinical performance and rewarding hospitals based on unreliable data.”
CMS plans to publish the data from measure OP-15 on their internet site Hospital Compare.
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