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Research ArticleCONTINUING EDUCATION

Quality and Value of Nuclear Medicine and Molecular Imaging: The Impact of Health-Care Reform

Kristi R. Mitchell and Susan K. Bunning
Journal of Nuclear Medicine Technology March 2013, 41 (1) 3-8; DOI: https://doi.org/10.2967/jnmt.112.117051
Kristi R. Mitchell
1Avalere Health, LLC, Washington, District of Columbia; and
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Susan K. Bunning
2Society of Nuclear Medicine and Molecular Imaging, Reston, Virginia
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    FIGURE 1.

    Timeline of key quality improvement efforts.

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    TABLE 1

    A Variety of Payment Reform Approaches Emerges

    BundledEpisodeConditionGlobal
    Payment for a tightly linked set of services provided by one or a small number of providersPayment for all or most services delivered by related providers attendant to a time-delimited “episode of care” (e.g., hip replacement surgery and rehabilitation)Payment for all or most services delivered by related providers attendant to a specified disease or condition, such as asthma, over a specified timePayment for all or most services delivered by related providers to a heterogeneous population (e.g., Medicare Advantage program)
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    TABLE 2

    2012–2013 Imaging Efficiency Measures (11)

    20122013
    OP-8: MRI lumbar spine for low back painOP-15: use of brain CT in the emergency department for atraumatic headache
    OP-9: mammography follow-up rates
    OP-10: abdominal CT use of contrast material
    OP-11: thoracic CT use of contrast material
    OP-13: cardiac imaging for preoperative risk assessment for noncardiac low-risk surgery
    OP-14: simultaneous use of brain CT and sinus CT
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    TABLE 3

    Finalized PQRS Individual Quality Measures Relevant for Nuclear Medicine Physicians Available for Reporting for 2013 and 2014 (12)

    PQRS no.Measure
    2013 reporting
     10Stroke and stroke rehabilitation: CT or MR imaging reports
     21Perioperative care: venous thromboembolism prophylaxis (when indicated in all patients)
     24Osteoporosis: communication with physician managing ongoing care after hip, spine, or distal radius for men and women aged 50 y and over
     40Osteoporosis: management after hip, spine or distal radius for men and women aged 50 y and over
     76Prevention of catheter-related bloodstream infections: central venous catheter insertion protocol
     145Radiology: exposure time reported for procedures using fluoroscopy
     146Radiology: inappropriate use of “probably benign” assessment category in mammography screening
     147Nuclear medicine: correlation with existing imaging studies for all patients undergoing bone scintigraphy
     195Radiology: stenosis measurement in carotid imaging studies
     225Radiology: reminder system for mammograms
     TBDCardiac stress imaging not meeting appropriate-use criteria: preoperative evaluation in low-risk surgery patients
     TBDCardiac stress imaging not meeting appropriate-use criteria: routine testing after percutaneous coronary intervention
     TBDCardiac stress imaging not meeting appropriate-use criteria: testing in asymptomatic, low-risk patients
    2014 reporting
     TBDRadiation dose optimization: use of a standardized nomenclature for CT imaging description
     TBDRadiation dose optimization: cumulative count of potential high-dose-radiation imaging studies: CT scans and cardiac nuclear medicine scans
     TBDRadiation dose optimization: reporting to a radiation dose index registry
     TBDRadiation dose optimization: images available for patient follow-up and comparison purposes
     TBDRadiation dose optimization: search for prior imaging studies through a secure, authorized, media-free shared archive
    • TBD = to be determined.

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    TABLE 4

    Meaningful Use and the Adoption of Health Information Technology (13)

    Meaningful-use stageDescription
    1Capturing electronic health information and using those data to track and communicate clinical conditions
    2Increased focus on health information exchange; mobilization of electronic health information across organizations within a region, community, or health system; electronic orders and results
    3Emphasis on quality, safety, and efficiency; promotion of decision support systems and patient access to self-management tools
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Journal of Nuclear Medicine Technology: 41 (1)
Journal of Nuclear Medicine Technology
Vol. 41, Issue 1
March 1, 2013
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Quality and Value of Nuclear Medicine and Molecular Imaging: The Impact of Health-Care Reform
Kristi R. Mitchell, Susan K. Bunning
Journal of Nuclear Medicine Technology Mar 2013, 41 (1) 3-8; DOI: 10.2967/jnmt.112.117051

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Quality and Value of Nuclear Medicine and Molecular Imaging: The Impact of Health-Care Reform
Kristi R. Mitchell, Susan K. Bunning
Journal of Nuclear Medicine Technology Mar 2013, 41 (1) 3-8; DOI: 10.2967/jnmt.112.117051
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    • DELIVERY AND PAYMENT REFORM
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