Study of Medicare Claims Data Supports Retaining IOAS Exemptions

A new study of Medicare claims data commissioned by the AAOS State Legislative and Regulatory Initiatives Committee clearly demonstrates that there is no statistically significant difference in MRI utilization between orthopaedic surgeons who own MRI equipment and those who do not. The findings indicate that any changes in Medicare policy related to the current law, which allows self-referral for certain physician activities such as imaging, physical therapy, pathology, radiology and durable medical equipment, will not lead to reduced advanced imaging utilization.

The study was conducted by Oxford Outcomes (ICON), with lead researcher Robert L. Ohsfeldt, PhD, of Texas A&M University. Its approach was new and more robust than previous studies because it used a matching process that compares truly similar practices. The study created multiple cohorts within the division of practices that owned an MRI or did not. These more narrow cohorts were based on the most salient practice characteristics.

For example, within the two major ownership cohorts (MRI and non-MRI), there were smaller cohorts based on the number of physicians n each practice.  This enabled direct comparisons of MRI practices with multiple physicians with non-MRI practices with the same number of physicians. Previous studies did not have an appropriate comparison group and/or did not follow physician practices longitudinally.

The study involved a web-based survey of orthopaedic surgery practices to determine if and when the practice first acquired onsite MRI capacity. Then it built on the survey results by obtaining Medicare claims data for a sample of physicians affiliated with orthopaedic practices before or after onsite MRI acquisition as well as for a comparison sample of physicians in orthopaedic practices without onsite MRI capacity.  This enabled them to investigate any changes in patterns of MRI use associated with the acquisition of onsite MRI capacity.

In all of the models, the findings indicated that the estimated impact of acquiring onsite MRI capacity on the change in Medicare MRI volume is consistently s mall and not statistically significant.

For more information on the study,click here.