National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 3 of 3 Research Studies DisplayedWhaley CM, Zhao X, Richards M
Higher Medicare spending on imaging and lab services after primary care physician group vertical integration.
This study looked at the impact of direct ownership of physician practices by hospitals and health systems (vertical integration) on Medicare spending for imaging and lab services. A 100% sample of 2013-16 Medicare fee-for-service claims data was examined to determine if vertical integration was associated with changes in site of care and Medicare reimbursement rates for ten common diagnostic imaging and laboratory services. After vertical integration, the monthly number of diagnostic imaging tests per 1,000 attributed beneficiaries increased in a hospital setting by 26.3 per 1000, and the number performed in a nonhospital setting decreased by 24.8 per 1,000. Hospital-based laboratory tests increased by 44.5 per 1,000 and non-hospital-based laboratory tests decreased by 36.0 per 1,000. Average Medicare reimbursement rose by $6.38 for imaging tests and $0.57 for laboratory tests. This translates to $40.2 million increase for imaging and $32.9 million increase for laboratory tests in Medicare spending for the study period.
AHRQ-funded; HS024067.
Citation: Whaley CM, Zhao X, Richards M .
Higher Medicare spending on imaging and lab services after primary care physician group vertical integration.
Health Aff 2021 May;40(5):702-09. doi: 10.1377/hlthaff.2020.01006..
Keywords: Medicare, Healthcare Costs, Imaging, Primary Care
Hong AS, Levin D, Parker L
Trends in diagnostic imaging utilization among Medicare and commercially insured adults from 2003 through 2016.
This study examined trends in use of noninvasive diagnostic imaging (NDI) among commercially insured individuals compared to Medicare enrollees from 2003 through 2016. There was more of an increase among Medicare enrollees than commercially insured patients, but both showed upward trends until the early 2010’s where trends began to be flat or decline. The notable exception was for CT imaging among commercially insured patients aged 45-64 years and Medicare enrollees after 2012.
AHRQ-funded; HS022418.
Citation: Hong AS, Levin D, Parker L .
Trends in diagnostic imaging utilization among Medicare and commercially insured adults from 2003 through 2016.
Radiology 2020 Feb;294(2):342-50. doi: 10.1148/radiol.2019191116..
Keywords: Diagnostic Safety and Quality, Medicare, Imaging, Healthcare Utilization, Health Insurance
Kim EH, Vetter JM, Kuxhausen AN
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
The researchers evaluated the utilization of follow-up imaging after nephrectomy for renal cell carcinoma (RCC) in nationally representative data. Using Surveillance, Epidemiology, End Results (SEER) data, they found that, in the Medicare population, surveillance imaging is performed in a limited number of patients following nephrectomy for RCC but that increasing tumor stage is predictive of both increased chest and abdominal imaging surveillance.
AHRQ-funded; HS019455.
Citation: Kim EH, Vetter JM, Kuxhausen AN .
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
Urol Oncol 2016 May;34(5):237.e11-8. doi: 10.1016/j.urolonc.2015.11.017.
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Keywords: Cancer, Healthcare Utilization, Imaging, Medicare