Reducing clinical variation is a critical step to reign in America's healthcare costs. In a recent Verras blog post, Dan Woods provides a brief case study of one hospital's experience in reducing MRI variation.
Some physicians were ordering twice as many MRIs as other physicians at the hospital, leading to significant variations in clinical practice. Furthermore, many tests were not urgent to the patients' outcomes. In many cases, the MRIs were so non-urgent that patients were discharged before the MRI results were even received.
MRIs have a significant financial impact for Medicare patients, since the federal program does not reimburse for MRIs in the inpatient setting but will do so on an outpatient basis. The hospital enacted a physician-directed best practice protocol, including some of the following key steps:
• A set of criteria was established, designed to determine whether inpatient MRIs were necessary.
• A consultation and approval process was enacted to review all cases that fell outside of the established criteria.
• MRIs performed on patients outside the criteria were tracked and monitored. "This allows the criteria to be dynamic," according to the blog post, and over time criteria could be adjusted to reflect evidence-based medicine.
The protocol did not take away physicians' ability to order MRIs, but instilled more structure in the process. Once the best practices were established, inpatient MRIs ultimately fell by 51 percent, according to the report.
Study: More Expensive Care May Be Better
Specialty Boards Recommend Less Frequent Use of 45 Common Tests, Procedures
Some physicians were ordering twice as many MRIs as other physicians at the hospital, leading to significant variations in clinical practice. Furthermore, many tests were not urgent to the patients' outcomes. In many cases, the MRIs were so non-urgent that patients were discharged before the MRI results were even received.
MRIs have a significant financial impact for Medicare patients, since the federal program does not reimburse for MRIs in the inpatient setting but will do so on an outpatient basis. The hospital enacted a physician-directed best practice protocol, including some of the following key steps:
• A set of criteria was established, designed to determine whether inpatient MRIs were necessary.
• A consultation and approval process was enacted to review all cases that fell outside of the established criteria.
• MRIs performed on patients outside the criteria were tracked and monitored. "This allows the criteria to be dynamic," according to the blog post, and over time criteria could be adjusted to reflect evidence-based medicine.
The protocol did not take away physicians' ability to order MRIs, but instilled more structure in the process. Once the best practices were established, inpatient MRIs ultimately fell by 51 percent, according to the report.
More Articles on Healthcare Costs:
Price Tags of Preventive Services Costs Could Vary Up to 755%Study: More Expensive Care May Be Better
Specialty Boards Recommend Less Frequent Use of 45 Common Tests, Procedures