The measures on the use of medical imaging show how often a hospital provides specific imaging tests for Medicare beneficiaries under circumstances where they may not be medically appropriate. Lower percentages suggest more efficient use of medical imaging. The measures apply only to Medicare beneficiaries enrolled in Original Medicare who were treated as outpatients in hospital facilities reimbursed through the Outpatient Prospective Payment System (OPPS). These measures do not include Medicare managed care patients, non-Medicare patients, or patients who were admitted to the hospital as inpatients. Six Outpatient Imaging Efficiency measures are publicly reported.:
Publicly reported 30-day risk-standardized payment includes measures for:
Payment measures calculate the risk-standardized payments for a 30-day episode of care beginning with a hospitalization for AMI, HF, or pneumonia. While these measures only include Medicare fee-for-service beneficiaries, they capture payments made by patients and other insurers.