Medicare decision support demo to focus on imaging services

Recruited practices will receive immediate feedback about whether the MRIs and CT scans they order for patients are appropriate.

By David Glendinning — Posted Feb. 16, 2011

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

The Centers for Medicare & Medicaid Services has chosen five large health systems to help test whether physician clinical decision support systems lead to more appropriate use of advanced imaging services.

The two-year Medicare demonstration will include physician practices recruited by Brigham & Women's Hospital in Boston; Henry Ford Health System in Detroit; Maine Medical Center-Physician Hospital Organization in Portland; National Imaging Associates in Avon, Conn.; and the University of Wisconsin- Madison. CMS will test whether decision support boosts appropriate utilization of certain types of magnetic resonance imaging, computed tomography and nuclear medicine.

When such imaging is ordered for fee-for-service Medicare beneficiaries in the practices, the decision support systems will provide immediate feedback to doctors as to whether the tests are considered appropriate for the patients. Appropriateness assessments will be based on clinical guidelines endorsed by medical specialty societies, CMS said. The demonstration will not affect normal policy governing whether Medicare covers the screenings or what it will pay doctors for them, although physician participants will receive additional payment to provide data to the agency.

CMS Administrator Donald M. Berwick, MD, said the demonstration, required by Congress under 2008 legislation, could help cut down on the effects of inappropriate imaging scans on patients.

"The demonstration provides CMS an opportunity to work closely with individual conveners and physician practices in testing whether the use of decision support systems can improve quality of care by diminishing patient exposure to potentially harmful radiation caused by unnecessary overutilization of advanced imaging services," Dr. Berwick said.

The 11 imaging procedures targeted were chosen because Medicare spends a significant amount covering the scans for seniors, and because medical specialties have developed guidelines for their use. They are:

  • Spect MPI
  • MRI lumbar spine
  • CT lumbar spine
  • MRI brain
  • CT brain
  • CT sinus
  • CT thorax
  • CT abdomen
  • CT pelvis
  • MRI knee
  • MRI shoulder

Additional information about the imaging demo can be found online (link).

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn