Study: New imaging efficiency measure for ED use of CT for headaches not reliable or accurate
A new study suggests that there are serious problems with the Centers for Medicare and Medicaid Services' (CMS) new imaging efficiency measure for ED use of computed tomography (CT) for headaches. The study, which was published in the Annals of Emergency Medicine, concludes that the measure, OP-15, is not reliable or accurate, and that it produces misleading information about hospital ED performance.1
The measure, which is included in the hospital outpatient quality reporting program for calendar year 2012, uses Medicare billing records to assess whether CTs are clinically appropriate for headache patients. However, when study researchers reviewed medical records for headache patients whom CMS concluded had inappropriate brain CT scans in a trial run of the measure, they found that more than half (65%) of these CT scans actually complied with CMS' measure, and that there were valid reasons for the CT scans in another 18% of patients.
The authors are calling on CMS to remove OP-15 from any calculations pertaining to the outpatient prospective payment system or value-based purchasing. And the American Hospital Association opposes use of the measure as well, noting that the measure has not been endorsed by the National Quality Forum as a valid and reliable measure of care.
Reference
- Schuur J, Brown M, Cheung D, et al. Assessment of Medicare's imaging efficiency measure for emergency department patients with atraumatic headache. Ann Emerg Med. Feb. 23, Epub ahead of print.
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