Table 2. The 12 Low-Value Services and Denominator Descriptions, as Well as the Total Low-Value Service Counts and Spread Across Hospitals.
| Measure | Numerator | Denominator | Cohort A hospitals (n = 2415)a | Cohort B hospitals (n = 1350) | Comp. weight (%) | ||
|---|---|---|---|---|---|---|---|
| Total No. | Rate (N/D) per 100 | Total No. | Rate per 100 | ||||
| Procedures | |||||||
| Knee arthroscopy | Arthroscopic debridement/chondroplasty of the knee with diagnosis of osteoarthritis or chondromalacia in the procedure claim | Patient volume | 105 459 | 0.03 | 71 296 | 0.03 | 8.4 |
| Vertebroplasty | Vertebroplasty for osteoporosis fractures | Patient volume | 94 200 | 0.03 | 80 429 | 0.03 | 7.2 |
| IVC filter | IVC filter | Patient volume | 40 916 | 0.01 | 35 974 | 0.01 | 3.1 |
| Renal artery stenting | Renal artery stenting for hypertension | Patient volume | 12 239 | 0.003 | 11 207 | 0.004 | 0.9 |
| Hysterectomy | Hysterectomy for benign disease | All hysterectomies | 97 831 | 65.4 | 81 601 | 62.5 | 7.6 |
| CEA | Carotid endarterectomy for patients without stroke/TIA | All carotid endarterectomies | 47 612 | 52.4 | 44 556 | 52.3 | 3.6 |
| Coronary stents | Coronary artery stenting for stable heart disease | All coronary artery stents | 199 579 | 24.8 | 186 550 | 24.8 | 15.1 |
| Spinal fusion | Spinal fusion without radicular pain, herniated disc | All spinal fusions | 72 258 | 20.5 | 65 866 | 20.4 | 5.5 |
| Diagnostic tests and imaging | |||||||
| EEG for syncope | EEG for syncope | All claims with primary diagnosis of syncope (with exclusions)b | 77 084 | 3.6 | 60 988 | 3.6 | 5.9 |
| EEG for headache | EEG for headache | All claims with primary diagnosis of headache (with exclusions) | 7433 | 0.38 | 5886 | 0.38 | 0.6 |
| Carotid artery imaging for syncope | Carotid artery imaging for syncope | All claims with primary diagnosis of syncope (with exclusions)c | 131 236 | 11.0 | 96 231 | 10.6 | 10.8 |
| Head imaging for syncope | Head imaging for syncope | All claims with primary diagnosis of syncope (with exclusions)c | 377 745 | 27.0 | 271 905 | 25.3 | 31.4 |
Abbreviations: CEA, carotid endarterectomy; comp, composite; EEG, electroencephalogram; IVC, inferior vena cava; N/D, numerator/denominator; TIA, transient ischemic attack.
a
Cohort A hospitals had capacity for 7 or more services, whereas cohort B hospitals had capacity for 12 services (excluding pulmonary artery catheterization).
b
Syncope defined using International Classification of Diseases, Ninth Revision (ICD-9) codes from Segal: 78.02, 99.21, 33.701.
c
Syncope defined using ICD-9 codes from Schwartz: 78.02, 99.21.