This NQF project seeks to identify and endorse measures for public accountability and quality improvement related to the appropriateness and efficiency of outpatient imaging at the practitioner and facility level.
The
cost of imaging studies is approximately $100 billion. A significant
portion – as much as $30 billion – is due to inappropriate utilization
of imaging or duplication of studies1.
The use of expensive imaging studies, such as magnetic resonance
imaging (MRI), is rising rapidly. In the Medicare population the
number of musculoskeletal MRI studies performed increased 134 percent
from 1999 to 2005; at the same time, the number of conventional
skeletal radiographs performed on these patients decreased by four percent2.
To date, NQF has endorsed two measures for appropriate use of imaging
in patients with low back pain. This project seeks to reach consensus
on standardized measures of the appropriateness and efficiency
of diagnostic imaging services, particular by outpatient providers
that will effectively improve the care of patients and reduce excessive
healthcare costs.
NQF intends to formally solicit measures that address appropriate and efficient
use of diagnostic imaging in the outpatient setting among healthcare providers,
including measures that specifically relate to the appropriateness and efficiency
of imaging services, including both the quality and cost of imaging services.
These measures will particularly examine the significant clinical, systems
and care coordination aspects involved in the efficient delivery of high-quality
services.
The candidate measures will be considered for NQF endorsement as voluntary
consensus standards. Agreement around the recommendations will be developed
through NQF’s formal Consensus Development Process (version 1.8). This project,
like all NQF activities, involves the active participation of representatives
from across the spectrum of healthcare stakeholders and is guided by a Steering
Committee.
Funding for this project has been provided by the Centers for Medicare & Medicaid
Services. For more information, contact Del M. Conyers, MPH, at
202.783.1300 or via email, imagingefficiency@qualityforum.org.
1Health Care Financing Administration. 1999 HCFA statistics. Washington, DC: US Government Printing Office; April 2000. HCFA publication 03421.
2Nunley RM, Sharan A, Mehta S, et al. Radiology utilization presents referral, payment challenges. AAOS Now [serial online]. 2007. Available at: http://www.aaos.org/news/bulletin/jul07/reimbursement1.asp. Last accessed May 29, 2008.