RAYUS Radiology reports, CDI Quality Institute, a non-profit affiliate, one of the nation’s leading national subspecialty providers for advanced diagnostic and interventional radiology services, once again qualified as a Provider-led entity (PLE) for the Medicare Appropriate Use Criteria (AUC) Program with the Centers for Medicare & Medicaid Services (CMS).
PLE designation from CMS, the largest healthcare payor in the United States, is granted to a select group of organizations nationwide who are tasked with providing real-time clinical guidance to treating physicians ordering diagnostic imaging procedures such as MRI, CT and PET exams. Currently, only 22 federally qualified organizations nationwide hold the notable designation that the Quality Institute first earned in 2016.
The Quality Institute is supported by more than 250 sub-specialty trained radiologists and top specialists within RAYUS’ growing nationwide network. Since its inception in 2003, the Quality Institute has helped define quality measures to ensure patients receive the right diagnostic test or radiological procedure at the right time and, in turn, reduce any unnecessary care – and unnecessary health care spend.
“We are privileged to be among such an illustrious and highly skilled group of pioneers in the development of appropriate use criteria for diagnostic imaging,” said RAYUS Radiology Chief Executive Officer Kim Tzoumakas. “The RAYUS nationwide network of clinical experts is growing rapidly and, as a result, the evidence-based knowledge that contributes to our ability to help provide the highest quality care is growing along with us.”
Starting in 2023, if a newly released draft rule is enacted as written, all clinicians will be required to consult AUC, like those developed by the RAYUS Quality Institute, when ordering the most advanced imaging tests (MRI and CT) under Medicare coverage guidelines.
The RAYUS Quality Institute and its robust clinical library provide high-level quality support to the physician, medical center and research communities, including providing summary criteria documents distributed to ordering physicians and producing The Consult, a quarterly publication of the Quality Institute for clinicians. Additionally, developed criteria are licensed to AIM Specialty Health, a subsidiary of Anthem, that serves more than 52M members and 330K ordering physicians nationwide, and Infinx Healthcare.
“All of us involved with our Quality Institute’s work in providing best-practice utilization guidelines and other clinical decision support tools are proud to be an important resource to our radiologists, our referring physicians, and our patients in continuing to advance the level of care,” said Dr. Thomas Gilbert, RAYUS Radiology’s Chief Clinical Officer.
Both the Quality Institute and the affiliated RAYUS Radiology network grew from the well-established roots of the former Center for Diagnostic Imaging (CDI). CDI became RAYUS Radiology in June as part of national rebranding and associated ‘SHINE ON’ campaign celebrating CDI’s distinguished 40-year legacy in the radiological field, its people and the ongoing national growth and expansion planned for the network.
