Physicians interested in testing how decision-support technology may help reduce unnecessary radiation exposure from advanced imaging services, as well as improve overall quality of patient care, should start preparing their proposals to participate in the two-year Medicare Imaging Demonstration, the latest-announced pilot included in the health reform law.

For the $10 million demonstration, CMS will select 2,500 to 3,000 physicians from 500 to 650 practices across a mix of sizes, specialties and geographic areas to use a decision-support system (DSS) to immediately assess the appropriateness of a test ordered for a patient. All appropriateness criteria built into the systems used in the demonstration, as required by law, will be based those developed or endorsed by medical specialty societies, CMS says.

Chosen based on high spending and utilization within the Medicare fee-for-service population, the 11 procedures included in the demonstration will include SPECT MPI, MRI lumbar spine, CT lumbar spine, MRI brain, CT brain, CT sinus, CT thorax, CT abdomen, CT pelvis, MRI Knee and MRI shoulder.

A sound DSS, of which there are currently about five on the market, should help physicians determine not just whether a scan is necessary, but the best test for the circumstances, Joshua Cooper, senior director of government relations for the American College of Radiology, told HealthLeaders Media. "Sometimes, the most expensive test is the right test, and when it is, it should be the first test," he says.

To orchestrate the project, CMS will appoint "conveners," which may include physician groups, integrated healthcare delivery systems, independent practice associations, radiology benefit managers or others, to recruit physician practices, deploy and monitor a specialty-specific DSS, process the data practices collect and distribute payments to physician practices.

CMS is also interested in recruiting a diverse group of conveners, who will also be paid for their work. Applications for those interested in participating in the project as providers or conveners are due to CMS by Sept. 21.

To learn more:
- see this piece from HealthLeaders Media
- read the story on HealthImaging.com
- read the press release from CMS
- see the notice in the July 23 Federal Register

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