Understanding The Assessment Score Card Your Score Card 1. Site Score 2. Modality Score(s) ... The body parts listed on your score card may not include ALL covered body parts in the

Understanding The Assessment Score Card

Understanding Your Score Card

Site Score1.

Modality Score(s)2.

The OptiNet score card is divided into section scores based on the information that your facility provided during the registration process. The scores are based on the following categories:

A = 88-100 B = 76-87 C = < 76

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.

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.

Modality Total4.The Modality total is calculated using the following formula: (Site Score * 1/3) + (Modality-specific Score *2/3) = Modality total.

Score Weight/ Raw Score/ Weighted Score3.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.

Grade Ranges:

Your Score Card Costs

Body Part1.

Average allowed cost by CPT grouper2.

The displayed values represent the average allowed amount for the combined professional and technical components based on previously billed services:

For each body part, AIM groups similar CPT codes within each category (for example, the codes include those with and without use of contrast agents). The body parts listed on your score card may not include ALL covered body parts in the AIM program. The score card will only display those body parts for which there is historical claims activity from this provider TIN.

The displayed values represent the average allowed amount for the combined professional and technical components based on previously billed services.

( Display List )

( Provider Search Results List )

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Cost Index:Displays the average price for exams

Site Score Index:Displays the composite score

How Will Scores Be Displayed?

Display List

The system shall display a list of up to 10 servicing providers based on proximity to the member’s home address. Cost and site scores will be shown in 2 columns, sorted first by Site Score and then in ascending order by cost.

1.

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. For cases where multiple modalities are ordered (CT and MR, for example), site scores are averaged and the costs are summed.

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The modality scores will be displayed to ordering providers when they submit order requests. Only providers who have completed an assess-ment will be on the initial display list.

OptiNet

Key Points:While the OptiNet assessment 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 (ARRT(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– If an MR machine has undergone a major software upgrade

the system will calculate the age based on the upgrade year, not manufacturer date.

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

What information was used to calculate my scores?Scores are calculated using information submitted by each facility through the online registration assessment. Facilities can view, edit and update their responses by accessing their assessment results online.

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 ARRT(R) certification)

• Modality Certification (10% of weighted scoring): Accreditation of machine by a primary accrediting body

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 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.

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 high-tech body part/CPT grouper.

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.

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 assessment. 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:

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AIM 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 AIM Network Management Representative.

Sample Modality and Site Score:

Modality Specific Score: 65

Site Score: 50

Modality Score Calculation:

65 x 2/3 = 43.5

50 x 1/3 = 16.5

Total = 60.0

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