News | September 14, 2011

ACC’s Appropriate Use Criteria Supported by Insurer for Cardiac Imaging Exams

September 14, 2011 – The Delaware Insurance Commissioner’s announcement that Blue Cross Blue Shield of Delaware (BCBSD) will support physicians’ use of an American College of Cardiology (ACC) program to make decisions about certain diagnostic imaging tests is a win for patients and a win for quality-of-care, said ACC CEO Jack Lewin, M.D.

Commissioner Karen Weldin Stewart on Tuesday announced an agreement with BCBSD that the company will pay for Delaware physicians to participate in the ACC’s online appropriate-use criteria-based program, FOCUS: Cardiovascular Imaging Strategies. The program supports physician decision-making and the use of best practices for decisions regarding cardiovascular diagnostic imaging. The agreement followed a state review of patient complaints about practices related to pre-authorization for nuclear cardiac imaging tests and concerns raised in the report about differences in criteria used by physician and insurers for nuclear cardiac imaging tests.

“In order to solve this problem, we need to get everyone on the same page as to when the studies are appropriate,” Stewart said in announcing the agreement. “With this new program, BCBSD is using the best criteria developed by the expert physicians, the American College of Cardiology, and will pay to have Delaware physicians using the best medical criteria.”  

FOCUS uses a computer-based tool developed by the ACC to help guide physicians when ordering imaging tests.  The tool applies nationally accepted, transparent and physician-developed appropriate use criteria to guide ordering of nuclear cardiac imaging tests. FOCUS allows local physicians to consistently apply appropriate use criteria to determine when patient tests are needed.  Importantly, the program provides feedback reports on the patterns of appropriate use to physician practices and health plans.  FOCUS participants then use the reports to complete action plans and share best practices.

“This decision is a win for patients and a win for evidence-based medicine,” Lewin said. “Commissioner Stewart and her staff should be commended for providing a solution that is based on physician-developed appropriate use criteria. This type of approach results in better care for patients and can ultimately save money. We hope Delaware will be a model for managing medical costs by focusing on patient-centered decision making and quality care.”

For more information: www.cardiosource.org/focus

 

Related Content

ScImage and Invia Partnership Announced
News | Cardiac PACS| September 19, 2017
ScImage Inc. and Invia Imaging Solutions recently announced formation of a joint partnership at the American Society of...
CZT SPECT camera detectors offered by GE.

A display of CZT SPECT gamma camera detectors at RSNA 2016. These detectors are more sensitive than those used in older cameras, allowing for faster scans or lower radiation dose. 

Feature | Nuclear Imaging| September 19, 2017 | Dave Fornell
Cardiac nuclear myocardial perfusion imaging (MPI) has been a mature area of imaging for years, but has recently star
Philips Launches CardioMD IV Cardiac SPECT Solution at ASNC 2017
Technology | SPECT Imaging| September 15, 2017
September 15, 2017 — Philips highlighted its newest solution for...
ARTMS Products Inc. and GE Healthcare Team Up to Expand Cyclotron-Produced Radioisotopes
News | Radiopharmaceuticals and Tracers| August 30, 2017
ARTMS Products Inc. signed a strategic partnership with GE Healthcare around ARTMS’ proprietary QUANTM99 Irradiation...
Sponsored Content | Videos | Nuclear Imaging| August 24, 2017
Prem Soman, M.D., director of nuclear cardiology at the Heart and Vascular Institute, University of Pittsburgh, and p
Sponsored Content | Videos | Nuclear Imaging| August 24, 2017
Randy Thompson, M.D., attending cardiologist, St.
ASNC and SNMMI Release Joint Document on Diagnosis, Treatment of Cardiac Sarcoidosis
News | Cardiac Imaging| August 18, 2017
August 18, 2017 — The American Society of...
Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Cardiac Imaging| August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
New PET-CT Scan Improves Detection in Rare Cardiac Condition
News | PET-CT| July 25, 2017
Using a new imaging technique that can diagnose cardiac sarcoidosis much more accurately than traditional tests,...
Overlay Init