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Imaging Efficiency Measures

For Calendar Year (CY) 2016 payment determinations, six Outpatient Imaging Efficiency (OIE) measures are publicly reported within the Hospital Outpatient Quality Reporting (OQR) Program:

  • MRI Lumbar Spine for Low Back Pain (OP-8)
  • Mammography Follow-up Rates (OP-9)
  • Abdomen Computed Tomography – Use of Contrast Material (OP-10)
  • Thorax CT – Use of Contrast Material (OP-11)
  • Cardiac Imaging for Preoperative Risk Assessment for Non-Cardiac Low-Risk Surgery (OP-13)
  • Simultaneous Use of Brain CT and Sinus CT (OP-14)

These six publicly reported OIE measures are calculated using data from hospital outpatient claims paid under Medicare’s Outpatient Prospective Payment System (OPPS). Hospitals need not submit any additional data for calculation of the measures.

Beginning in CY 2016, the Centers for Medicare & Medicaid Services (CMS) has posted individual, measure-specific documentation (re-evaluation report) for each OIE measure. These reports replace previously posted materials, including the measure specification and technical note documents, literature reviews, and minimum case count tables. Each re-evaluation report contains: measure background and methodology; summary data from 2016 public reporting; results from the most recent environmental scan and literature review (ES/LR) and comprehensive reevaluation, where applicable; measure specifications and annual updates; and measure minimum case count rationale and methodology.

The specifications used to calculate results posted on Hospital Compare prior to July 2016 can be found on the Archived Measure Specifications page.

The specifications included in the documents below were used to calculate results reported on Hospital Compare beginning in July 2016. The OIE measures’ technical specifications are subject to periodic review that can result in changes reflecting advancements in clinical decision-making and technological advances. Specification changes may occur in a measure's numerator, denominator, and/or exclusions. Specifications are updated in response to Technical Expert Panel (TEP) feedback (convened annually) and other stakeholder input, as well as from results found in annual literature reviews.

CMS has provided a link to the reevaluation report for each measure, as well as page numbers for the measure specifications, annual updates, ES/LR results, and minimum case count table within each document to ease the transition to the new format.

Measure Reevaluation Reports for the OIE Measures

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