Advanced imaging use and payment trends in a large pediatric accountable care organization
- 17.09.2021
- Original Article
Erschienen in:
- Verfasst von
- Ramkumar Krishnamurthy
- Summit H. Shah
- Ling Wang
- Sean P. Gleeson
- Gilbert C. Liu
- Houchun H. Hu
- Rajesh Krishnamurthy
- Erschienen in
- Pediatric Radiology | Ausgabe 1/2022
Abstract
Background
Pediatric imaging use and payment trends in accountable care organizations (ACOs) are seldom studied but are important for health policy decisions and resource allocation.
Objective
To evaluate patterns of advanced imaging use and associated payments over a 7-year period at a large ACO in the USA serving a Medicaid population.
Materials and methods
We reviewed paid claims data from 2011 through 2017 from an ACO, analyzing the MRI, CT and US use trends and payments from emergency department (ED) and outpatient encounters. We defined “utilization rate” as the number of advanced imaging procedures per 100 enrolled children per calendar year. Average yearly utilization and payments trends were analyzed using Pearson correlation.
Results
Across 7 years, 186,552 advanced imaging procedures were performed. The average overall utilization rate was 6.99 (95% confidence interval [CI]: 6.9–7.1). In the ED this was 2.7 (95% CI: 2.6–2.8) and in outpatients 4.3 (95% CI: 4.2–4.3). The overall utilization rate grew by 0.7% yearly (P=0.077), with US growing the most at 4.0% annually (P=0.0005), especially in the ED in the US, where it grew 10.8% annually (P=0.000019). The overall payments were stable from 2011 to 2017, with outpatient MRI seeing the largest payment decrease at 1.8% (P=0.24) and ED US showing the most growth at 3.3% (P=0.00016). Head CT and abdominal US were the two most common procedures.
Conclusion
Over the study period, advanced imaging utilization at this large pediatric ACO serving the Medicaid population increased, especially with US use in the ED. Overall payments related to advanced imaging remained stable over this period.
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- Titel
- Advanced imaging use and payment trends in a large pediatric accountable care organization
- Verfasst von
-
Ramkumar Krishnamurthy
Summit H. Shah
Ling Wang
Sean P. Gleeson
Gilbert C. Liu
Houchun H. Hu
Rajesh Krishnamurthy
- Publikationsdatum
- 17.09.2021
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Pediatric Radiology / Ausgabe 1/2022
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998 - DOI
- https://doi.org/10.1007/s00247-021-05198-2
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