Stanford University, Department of Radiology, Neuroradiology Division, Stanford, California.
NYU Langone Health, Department of Radiology, New York, New York.
J Am Coll Radiol. 2021 May;18(5):704-712. doi: 10.1016/j.jacr.2020.12.011. Epub 2021 Jan 11.
The Radiology Support, Communication and Alignment Network (R-SCAN) is a quality improvement program through which patients, referring clinicians, and radiologists collaborate to improve imaging appropriateness based on Choosing Wisely recommendations and ACR Appropriateness Criteria. R-SCAN was shown previously to increase the odds of obtaining an appropriate, higher patient or diagnostic value, imaging study. In the current study, we aimed to estimate the potential imaging cost savings associated with R-SCAN use for the Medicare population.
The R-SCAN data set was used to determine the proportion of appropriate and lesser value imaging studies performed, as well as the percent change in the total number of imaging studies performed, before and after an R-SCAN educational intervention. Using a separate CMS data set, we then identified the total number of relevant imaging studies and associated total costs using a 5% sample of Medicare beneficiaries in 2017. We applied R-SCAN proportions to the CMS data set to estimate the potential impact of the R-SCAN interventions across a broader Medicare population.
We observed a substantial reduction in the costs associated with lesser value imaging in the R-SCAN cohort, totaling $260,000 over 3.5 months. When extrapolated to the Medicare population, the potential cost reductions associated with the decrease in lesser value imaging totaled $433 million yearly.
If expanded broadly, R-SCAN interventions can result in substantial savings to the Medicare program.
放射科支持、沟通和协调网络（R-SCAN）是一个质量改进计划，通过该计划，患者、转诊临床医生和放射科医生合作，根据明智选择和 ACR 适宜性标准，提高影像学的适宜性。先前的研究表明，R-SCAN 增加了获得适当的、更高的患者或诊断价值的影像学研究的可能性。在本研究中，我们旨在估计 R-SCAN 用于 Medicare 人群的潜在影像学成本节约。
使用 R-SCAN 数据集确定在进行 R-SCAN 教育干预前后，进行适当和较低价值影像学研究的比例，以及进行的影像学研究总数的百分比变化。然后，我们使用单独的 CMS 数据集，确定了 2017 年 Medicare 受益人的 5%样本中相关影像学研究的总数和相关总成本。我们将 R-SCAN 比例应用于 CMS 数据集，以估计 R-SCAN 干预对更广泛的 Medicare 人群的潜在影响。
我们观察到 R-SCAN 队列中较低价值影像学相关成本的大幅降低，在 3.5 个月内总计为 26 万美元。如果推广到 Medicare 人群，较低价值影像学减少所带来的潜在成本降低每年总计为 4.33 亿美元。
如果广泛推广，R-SCAN 干预可以为 Medicare 计划节省大量资金。
