Final Report: National Voluntary Consensus Standards for Outpatient Imaging Efficiency: A Consensus Report
The Opportunity
The cost of imaging studies has been estimated around $100 billion. A significant portion—as much as $30 billion—was 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 lower back pain. This project sought to reach consensus on standardized measures of the appropriateness and efficiency of diagnostic imaging services, particularly by outpatient providers that will effectively improve the care of patients and reduce excessive healthcare costs.
About the Project
This project ended in October 2008.
Objectives
In this project, NQF endorsed 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 examine the significant clinical, systems and care coordination aspects involved in the efficient delivery of high-quality services.
Process
The candidate measures were considered for NQF endorsement as national voluntary consensus standards. Agreement around the recommendations were developed through NQF's formal Consensus Development Process (CDP, version 1.8). This project, like all NQF activities, involved the active participation of representatives from across the spectrum of healthcare stakeholders and was guided by a Steering Committee.
Funding
Funding for this project was provided by the Centers for Medicare & Medicaid Services (CMS).
Contact Information
For more information, contact Del Conyers, MPH at 202-783-1300 or via email at dconyers@qualityforum.org.
Notes
1 Health 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.
This project endorsed eight measures for public accountability and quality improvement for appropriateness and efficiency of outpatient imaging at the practitioner and facility level.
NQF received measures to review for potential endorsement as national voluntary consensus standards.
The Steering Committee and Technical Advisory Panel met in person and by conference call numerous times in June and July. The steering committee reviewed all submissions and communicated with measure developers as needed to determine the measures to recommend for endorsement. Following this review period, the recommended measures were made available for public and member comment.
For the member voting period eight measures were presented in the draft report that reflected public and member comments from the open comment period. Voting ended at 6 p.m. ET on October 15, 2008.
Voting draft (PDF)
The CSAC voted to recommend endorsement of eight measures for outpatient imaging efficiency. The date, agenda and any supporting materials will be posted when available.
The Board of Directors ratified the CSAC’s decision to endorse eight measures for outpatient imaging efficiency. After the CSAC makes its final endorsements, the NQF Board has seven days to ratify the CSAC's decision. Any information pertaining to the Board's deliberations will be posted when available.
The public had 30 days to appeal the decision to endorse a voluntary consensus standard. Additional information will be posted when available. No appeals were submitted.
