What impact does MRI, CT utilization have on ACOs?

CMS data from accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) reveals that higher MRI utilization rates are associated with “small but significant” cost savings, according to a recent analysis published in the Journal of the American College of Radiology. No such correlation was seen for CT utilization rates.

Overall, more than 54 percent of ACOs achieved savings in 2014. More than 27 percent of those ACOs met their savings thresholds, meaning they achieved the required saving rate while also meeting various performance benchmarks.

“Independent positive predictors of the amount of total savings among the full cohort were average risk score for aged nondual beneficiaries and MRI events; the only independent negative predictor of savings was per capita expenditures,” wrote authors Andrew B. Rosenkrantz, MD, MPA, of the department of radiology at NYU Langone Medical Center in New York City, and Richard Duszak Jr., MD, of the department of radiology at Emory University in Atlanta. “In contrast, CT events were not independent predictors.”

In the past, the authors added, “downstream outcomes” have not been fully considered when researchers have explored the implications associated with MRI utilization, limiting the industry’s understanding of its greater impact.

“From such a narrow vantage point, MRI utilization serves solely as a cost driver,” Rosenkrantz and Duszak wrote. “However, appropriate imaging utilization has the potential to yield earlier and more accurate diagnoses and thus obviate the need for further subsequent testing and interventions. Accordingly, the true value of advanced imaging may become apparent when more fully considering its downstream effects.”

Before too much is read into these findings, the authors explained, MSSP-participating ACOs represent organizations that generally go above and beyond in terms of the quality of their care and the thoroughness of their reporting.

“More research will be necessary to determine if such associations exist in non-MSSP-participating healthcare organizations,” Rosenkrantz and Duszak concluded.