An Empiric Medicare Claims-Based Utilization Approach to Mitigating the Iodinated Contrast Shortage

• Type of Material: Article
• Authors: Richard Duszak Jr, Emory University; Jennifer Hemingway, Harvey L. Neiman Health Policy Institute; Eric W Christensen, University of Minnesota Twin Cities; Amit Saindane, Emory University; Danny Hughes, Emory University; Elizabeth Y Rula, Harvey L. Neiman Health Policy Institute
• Language: English
• Date: 2022-07-01
• Publisher: RELX
• Publication Version: Final Published Version
• Copyright Statement: © 2022 American College of Radiology.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jacr.2022.05.012
• Title of Journal or Parent Work: Journal of the American College of Radiology
• Volume: 19
• Issue: 7
• Start Page: 846
• End Page: 848
• Keywords: Insurance Claim Review; United States; Medicare
• Research Categories: Health Sciences, Radiology; Health Sciences, Medicine and Surgery

Abstract

Recent coronavirus disease of 2019 (COVID-19)–related lockdowns in China resulted in the shutdown of the GE Healthcare factory responsible for production of most of the iodinated contrast used in the United States [1]. Given increased clinical reliance on CT, which often includes the need for intravenous contrast, for the diagnosis and follow-up of a variety of conditions and its associated dramatic utilization growth over recent decades [2], disruptions in patient care have already occurred and are anticipated to continue. The ACR recently released recommendations to help mitigate that impact [3], and individual centers are beginning to share their institutional approaches and experience [4,5]. Those early reports have largely been clinically focused, highlighting interdisciplinary collaboration, operational opportunities (eg, dosing and alternative contrast agents), and care pathways (eg, oncology versus other diseases). Given the daunting challenges associated with most effectively rationing of limited contrast resources, we believe that empiric utilization data could help prioritize and inform professional society guidelines and health system decision making by focusing mitigation strategies on areas in which contrast is most frequently used. Because institutional and enterprise data on local contrast agent utilization may be variable in availability, completeness, and quality, national benchmark information could prove useful. Using recent Medicare claims data, we thus detail CT services by body region and site of service in which iodinated contrast is used most frequently.