How Do You Decide Whether to Order a Stress Test?

In an observational analysis, the practice of billing for both technical and professional fees was associated with significantly increased likelihood of ordering a test.

How financial incentives influence physician practice is coming under increased scrutiny. To determine the association between physician billing practices and the use of stress testing after coronary revascularization, investigators examined administrative records from United Healthcare, an insurer that sponsored the study. Included were 17,847 adults (mean age, 55; 21% women) who had a cardiac-related outpatient visit (86% with no reported symptoms) >90 days after a coronary revascularization procedure performed between November 1, 2004, and June 30, 2007. Of cardiologists (who constituted about half of the billing physicians), 70% billed for technical and professional fees, 14% for professional fees only, and 16% for neither service.

Overa…

Reviewing Author

Harlan M. Krumholz, MD, SM

Disclosures

Consultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime

EquityHugo Health; Refactor Health; Element Science

Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association

Harlan M. Krumholz, MD, SM

Disclosures

Consultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime

EquityHugo Health; Refactor Health; Element Science