RBM begins Medicare imaging appropriateness project

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National Imaging Associates (NIA), a subsidiary of Magellan Health Services, has started a two-year demonstration study to assess the appropriate use of advanced imaging for Medicare Fee-for-Service beneficiaries. The research will examine the impact of physician decision support tools on mitigating the inappropriate use of MRI, CT and nuclear medicine.

The demonstration project is being conducted on behalf of the Centers for Medicare & Medicaid Services (CMS), which selected NIA along with four additional conveners for the study.

The study, which began in early October, has NIA working with multiple physician organizations totaling nearly 650 physicians.

Authorization for the project came from the Medicare Improvements for Patients and Providers Act of 2008. The study will be completed over two years and support systems will provide immediate feedback to help physicians determine whether a test is suitable and necessary for the patient based on appropriateness guidelines established by the medical community. It applies only to patients enrolled in the Medicare Fee-for-Service program and will not impact any Medicare patients that NIA currently manages.

Along with NIA, other conveners are Brigham & Women's Hospital in Boston, Henry Ford Health System in Detroit, Maine Medical Center - Physician Hospital Organization in Portland and the University of Wisconsin Medical Foundation in Madison.