Earlier this month, the National Quality Forum (NQF) endorsed four new measures aimed at tracking resource utilization within certain patient populations. The measures center on diabetes and cardiovascular care costs, requiring organizations to measure per member per month expenditures within each cohort. Maybe not surprisingly, CMS intends to add a similar measure to their VBP program aimed at isolating Medicare spending per beneficiary (MSPB).
These tandem efforts to redefine value of care may be indicators of what’s to come—increased scrutiny over total-cost-of-care management. As risk begins to shift towards providers with the advent of new payment models, organizations must learn to both understand and then inflect total cost of care in order to remain financially viable.
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The results of the highly anticipated CT-STAT trial were released this week in the Journal of the American College of Cardiology. The study objective was to compare the efficiency, cost, and safety of coronary CT angiography to rest-stress myocardial perfusion imaging to diagnose coronary artery disease (CAD) for emergent low-risk patients. Overall, CCTA was found to be more efficient and less costly than traditional SPECT imaging in the diagnostic work-up of this patient subset. While helping to further validate the role of CCTA to expedite care for appropriate chest pain patients, the study raises new questions about future opportunities for CCTA, and if it can supplant more established tests for diagnosing and ruling-out CAD.
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