放射科医生的网络外计费趋势,2007年至2021年
Jay R Parikh1, Alexandra R Drake2, Mikki D Waid3
1Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas; First Vice President, Texas Radiological Society, San Antonio, Texas; Chair, Committee on Fellowship Credentials, and Chair, Breast Ultrasound Accreditation Committee, American College of Radiology, Reston, Virginia.
Journal of the American College of Radiology : JACR
|January 20, 2024
概括
放射科医生网络之外 (OON) 影像索赔显著下降,从2007年的12.6%降至2021年的1.1%. 这一趋势表明了网络参与度的提高以及意外计费立法的潜在影响.
科学领域:
- 卫生经济学 卫生经济学
- 放射学 放射学是一门学科.
- 卫生政策 卫生政策
背景情况:
- 意外的医疗账单给患者带来了财务挑战.
- 了解放射科医生参与商业保险网络至关重要.
研究的目的:
- 评估放射科医生对网络外 (OON) 成像要求的趋势.
- 评估放射科医生参与商业保险网络的程度.
主要方法:
- 一项为期15年的回顾性研究 (2007-2021) 分析了来自Optum的Clinformatics Data Mart的索赔数据.
- 评估了整体的OON年率,对于住院住院和急诊室 (ED) 访问.
- 线性回归分析了跨成像模式的OON速率时间趋势.
主要成果:
- 放射科医生的OON索赔从2007年的12.6%下降到2021年的1.1%.
- 在住院期间,OON率为5.0%,在不导致入院的ED访问中为2.1%.
- 整体OON率每年下降0.74个百分点.
结论:
- 放射科医生的OON成像索赔的显著下降被观察到.
- 这一趋势可能反映了放射科医生和付款人之间的成功谈判.
- 新的州级意外计费法律也可能导致这一下降.
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