Instead of requiring preauthorization for clinicians who order too many imaging tests, Medicare should utilize existing decision-support tools to promote appropriate use of imaging, according to lobbying alliance Imaging e-Ordering Coalition.
On April 7, the Medicare Payment Advisory Commission (MedPAC) voted 15-1 to recommend that Medicare require clinicians who order more imaging studies than their peers to obtain prior authorization for advanced imaging. But the coalition said that Medicare officials should instead turn to decision-support systems to increase efficiency, support appropriate use, and improve quality of care in diagnostic imaging.
In making its case, the Imaging e-Ordering Coalition pointed to a three-year pilot program in Minnesota, which found that that point-of-order decision support was more efficient than calling in for prior authorization, had greater capacity for shared decision-making with patients, and could serve as a useful patient and provider education tool. Clinical decision support also generated monthly administrative savings of 303 hours compared to calling in for prior authorization, the coalition said.
