Abstract 21032: Effect of Financial Incentives on Cardiac Testing Rates
| Autor: | Fredrick Masoudi, Ali Moghtaderi, Bernard Black, David Magid, Samantha Schilsky, Timea Viragh |
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| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Circulation. 136 |
| ISSN: | 1524-4539 0009-7322 2005-2014 |
| Popis: | Introduction: In 2006, the Federal government concluded that overpayment was driving rapid growth of office-based cardiac stress testing. In response, the Centers for Medicare and Medicaid Services (CMS substantially reduced payments for Medicare fee-for-service (MFFS) office-based stress tests between 2007 and 2010, while at the same time holding constant or increasing payment for the same outpatient tests performed on hospital campuses. Objective: To compare changes in the rate and location of stress testing among MFFS and MA patients before and after the introduction of reduced MFFS office-based stress test payments. Methods: Cross-sectional study from 2005-2014 comparing the rate and location of stress tests for a random 5% sample of MFFS patients compared to patients enrolled in three large MA health plans that are paid on a capitated basis, and were not subject to these payment changes. Results: While overall stress testing rates decreased between 2005 and 2014 for both groups, the decline was greater for MA patients than MFFS patients. However, outpatient testing shifted from the lower-cost office setting to a higher-cost outpatient hospital setting for MFFS patients and to a lesser extent for MA patients. Conclusion: Our findings suggest that changes to the MFFS office - hospital payment differential had little effect on overall testing rate but shifted the location of outpatient testing to the hospital resulting in increasing testing costs for MFFS patients. |
| Databáze: | OpenAIRE |
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