American Imaging Management
American Imaging Management
American Imaging Management
Understanding
The Assessment Score Card
American Imaging Management
Understanding Your Score Card
The OptiNet score card is divided into section scores based on the
information that your facility provided in the registration survey. The
scores are based on the following categories:
1. Site Score
The Site Score measures basic performance indicators that are applicable for the facility as a whole, independent of any individual modality. These indicators include items such as: general site access,
quality assurance and staffing. The Site Score is not displayed, but
is a contributing factor for the individual Modality Scores that are
displayed in the application.
2. Modality Score(s)
Modality Scores measure basic performance indicators specific to each
modality within the facility. The Modality Score is comprised of two components: the facility’s Site Score and modality-specific scoring. The modality-specific scoring is based on indicators such as: MD certification,
technologist certification, modality accreditation, and equipment quality.
3. Score Weight/ Raw Score/ Weighted Score
The Site Score and individual Modality-specific Scores are calculated
using a weighted scoring system. Based on the responses submitted,
facilities receive a Raw Score between 0 and 100 for each factor. For
multiple machines within a modality, values are averaged. Each factor
is then multiplied by a Score Weight to produce a Weighted Score. For
example, the factor “Site QA” on the Site Score has a Score Weight of
20%. A facility receiving a Raw Score of 100 would earn a Weighted
Score of 20 (100 x .20) for that factor. Once all of the Weighted Scores
are calculated, they are added together to determine the overall score.
The maximum score that a facility can attain is 100.
4. Modality Total
The Modality total is calculated using the following formula:
(Site Score * 1/3) + (Modality-specific Score *2/3) = Modality total.
5. Cost Values
Cost values are determined based on the allowed amount of paid
claims from the previous year for both professional and technical
component claims. Costs are presented for each individual modality.
Grade Ranges:
A
= 88-100
B = 76-87
C = < 76
How Will Scores Be Displayed?
( Display List )
The modality scores will be displayed to ordering providers when they
submit order requests. Only providers who have completed an assessment will be on the initial display list.
1. Display List
1.
Cost and site scores will be shown in two columns, sorted first by Site Score and then in
ascending order by cost. Any providers who have
completed a registration and are within 30 miles of
the member’s home address will be displayed for
the modalities needed for the case.
( Provider Search Results List )
2. Provider Search Results List
If a user searches for a specific provider, and
that provider has incomplete assessment
information, the cost and/or Site Score columns
may display a “-” or “--” to indicate that there is
no data to display for that provider.
2.
For cases where multiple modalities are
ordered (CT and MR, for example), site scores are
averaged and the costs are summed.
Site Score Index:
Displays the composite
score
Cost Index:
Displays the average
price for exams
OptiNet
Key Points:
While the OptiNet survey collects a wide range of data, there are a few key factors that drive the overall modality scores. In order for a site to receive a score
of an A or a B, the following key factors need to be in place:
Physician staffing: (25% of weighted modality score)
There should be at least one Board-certified radiologist on-site at the facility.
In addition to radiologists, other specialties are also recognized for specific
modalities.
CT Neurology, Neurosurgery
CCTA Cardiology
MR Neurology, Neurosurgery and Orthopedics
Nuc Cardiology, Nuclear Medicine
PET Hematology and Oncology
Technologist staffing: (25% of weighted modality score)
There should be at least one technologist with modality-specific certification.
Technologists with basic radiology certification (AART(R) certification) earn
zero points.
Machine accreditation: (10% of weighted modality score)
Machines should be certified by ACR, IAC or one of the other recognized
accrediting bodies.
Machine quality: (15% of weighted modality score)
Machine quality does contribute to the overall score. The following
attributes are key factors for equipment quality:
Age of Machine
–Machines more than 7 years old earn zero points
CT
–Non-helical machines do not score high
–16-slice and higher machines get the highest
score; below 4-slice the lowest
CCTA
–64-slice and higher or EBCT machines get the
highest score; below 64-slice the lowest
MR
–Magnet strength of 1.5T or greater gets the highest score; below 1.0T the lowest
–Dedicated coils are important
PET
–Full ring machines score highly while
partial ring machines do not
?? ?
?
Frequently Asked Questions
Anthem understands that there may be questions about this
program. We hope this page will help answer the most frequently asked questions. Should you need to contact someone
regarding your scores or report, please contact your Anthem
Network Management Representative.
1.
2.
What information was used to calculate my scores?
Scores are calculated using information submitted by each facility through the online
registration survey. Facilities can view, edit and update their responses by accessing
their survey results at www.anthem.com.
How can I improve my scores?
Modality scores are determined from the range of indicators listed in the score card.
Modality-specific scoring is largely driven by a facility’s results in three key areas:
• Modality MD Certification (25% of weighted scoring): Presence of at least one
Board-certified radiologist or physician of another recognized specialty
• Modality Technologists (25% of weighted scoring): Presence of at least one
modality-certified technologist (beyond general AART(R) certification)
• Modality Certification (10% of weighted scoring): Accreditation of machine
by a primary accrediting body
3.
4.
Will purchasing a new piece of equipment improve my score?
Equipment age and quality each account for 10% of the total weighted score for each
modality. Based on the facility’s current results in these categories, new equipment may
or may not increase the facility’s score(s). It is also important to note that several other
factors such as MD and Technologist certifications and Accreditation, have a greater
impact on a facility’s score(s) than its equipment.
I’ve updated my information online but my score didn’t change. Why didn’t
my scores change?
Provider data changes are processed on a daily basis. New provider scores are
processed overnight, with updated scoring appearing the next day.
5.
What is the source of my cost value(s)?
Cost value is based on the allowed amounts of paid claims from the previous year for
both professional and technical component claims. Costs were averaged for each hightech modality.
6.
What is the difference between the Site Score and the Modality Scores?
The Site Score measures basic performance measures that are applicable for the facility
as a whole and are independent of any individual modality.
The Modality scores are comprised of two (2) components. One-third of each Modality
Score is based on the overall facility Site score. Two-thirds of each Modality Score is
based on the facility’s results in basic performance indicators specific to each modality
used at the site. See your score card for further details on score factors and weightings.
7.
How are the Site and Modality Scores calculated?
Site Scores are based on the facility’s results for eight (8) factors. Facilities can receive
a Raw Score between 0 and 100 points for each factor based on the responses
submitted through the online registration survey. For multiple machines within a modality,
values are averaged. Each factor is then multiplied by a Score Weight to produce a
Weighted Score. For example, the Factor “Site QA” has a Score Weight of 20%. A
facility that attained a Raw Score of 100 would receive a Weighted Score of 20 (100
x .20) for that Factor. Once all of the Weighted Scores have been calculated, they are
added together to attain the overall Site Score. The maximum Site Score that a facility
can attain is 100.
Modality scores are calculated based on the facility’s site score and modality-specific
scoring. Modality-specific scoring is generated in a similar manner to the Site Score.
Each modality has 6-7 modality factors. Facilities can receive a Raw Score between
0 and 100 points for each factor. Each factor is then multiplied by a Score Weight to
produce a Weighted Score. Once all of the Weighted Scores have been calculated, they
are added together to attain the overall modality specific score. The maximum modality
specific score that can be attained is 100.
The modality-specific scoring is then multiplied by 2/3. This product is then added to the
product of multiplying the Site Score by 1/3. The total is the Modality Score. An example
of this scoring is provided below:
Sample Modality and Site Score:
Modality Score Calculation:
Modality Specific Score: 65
65 x 2/3 = 43.5
Site Score: 50
50 x 1/3 = 16.5
Total
= 60.0
American Imaging Management
American Imaging Management
540 Lake Cook Road, Suite 300
Deerfield, Illinois 60015
www.americanimaging.net
American Imaging Management
American Imaging Management