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Financial incentives can be powerful mediators of change in healthcare. Starting in 2005, the Centers for Medicare and Medicaid Services (CMS) changed payments for noninvasive cardiac tests based on their venue, reducing payments for provider-based office (PBO) settings and increasing payments for hospital-based outpatient (HBO) settings. These investigators sought to describe trends in payments, testing rates, and testing locations from 1999 through 2015 in a study sample of 1.72 million patient-years annually in Medicare fee-for-service (FFS) and 142,230 patient-years annually in health maintenance organizations (control group).
Testing rates were about twice as high in the FFS group than in the control group throughout the study period. I…