Between Physician Billing and Cardiac Stress Testing Patterns Following Coronary Revascularization

Practice Management and Professionalism


Association Between Physician Billing and Cardiac Stress Testing Patterns Following Coronary Revascularization


Shah BR, Cowper PA, O’Brien SM, et al (Duke Univ Med Ctr, Durham, NC; et al) JAMA 306:1993-2000, 2011§



M.F. Roizen, MD



Evidence Ranking


• A



Expert Rating


• 1



Abstract



Context


The degree to which financial factors may influence use of cardiac stress imaging procedures is unknown.



Objective


To examine the association of physician billing and nuclear stress and stress echocardiography testing following coronary revascularization.



Design, Setting, and Patients


Using data from a national health insurance carrier, 17 847 patients were identified between November 1, 2004, and June 30, 2007, who had coronary revascularization and an index cardiac outpatient visit more than 90 days following the procedure. Based on overall billings, physicians were classified as billing for both technical (practice/equipment) and professional (supervision/ interpretation) fees, professional fees only, or not billing for either. Logistic regression models were used to evaluate the association between physician billing and use of stress testing, after adjusting for patient and other physician factors.



Main Outcome Measures


Incidence of nuclear and echocardiographic stress tests within 30 days of an index cardiac-related outpatient visit.

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Jan 28, 2017 | Posted by in ANESTHESIA | Comments Off on Between Physician Billing and Cardiac Stress Testing Patterns Following Coronary Revascularization

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