title: Accreditation status and geographic location of outpatient vascular testing facilities among Medicare beneficiaries: the VALUE (Vascular Accreditation, Location & Utilization Evaluation) study.
abstract: OBJECTIVE
  There is limited information on the accreditation status and geographic distribution of vascular testing facilities in the US. The Centers for Medicare & Medicaid Services (CMS) provide reimbursement to facilities regardless of accreditation status. The aims were to: (1) identify the proportion of Intersocietal Accreditation Commission (IAC) accredited vascular testing facilities in a 5% random national sample of Medicare beneficiaries receiving outpatient vascular testing services; (2) describe the geographic distribution of these facilities.
  
  
  METHODS
  The VALUE (Vascular Accreditation, Location & Utilization Evaluation) Study examines the proportion of IAC accredited facilities providing vascular testing procedures nationally, and the geographic distribution and utilization of these facilities. The data set containing all facilities that billed Medicare for outpatient vascular testing services in 2011 (5% CMS Outpatient Limited Data Set (LDS) file) was examined, and locations of outpatient vascular testing facilities were obtained from the 2011 CMS/Medicare Provider of Services (POS) file.
  
  
  RESULTS
  Of 13,462 total vascular testing facilities billing Medicare for vascular testing procedures in a 5% random Outpatient LDS for the US in 2011, 13% (n=1730) of facilities were IAC accredited. The percentage of IAC accredited vascular testing facilities in the LDS file varied significantly by US region, p<0.0001: 26%, 12%, 11%, and 7% for the Northeast, South, Midwest, and Western regions, respectively.
  
  
  CONCLUSIONS
  Findings suggest that the proportion of outpatient vascular testing facilities that are IAC accredited is low and varies by region. Increasing the number of accredited vascular testing facilities to improve test quality is a hypothesis that should be tested in future research.
authors.affiliation: Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA sbrown@med.miami.edu.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Brown
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Kefeng
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Chuanhui
authors.initials: C
authors.lastname: Dong
authors.affiliation: Intersocietal Accreditation Commission (IAC), Ellicott City, MD, USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Farrell
authors.affiliation: Intersocietal Accreditation Commission (IAC), Ellicott City, MD, USA.
authors.forename: Gary V
authors.initials: GV
authors.lastname: Heller
authors.affiliation: Department of Vascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Gornik
authors.affiliation: Intersocietal Accreditation Commission (IAC), Ellicott City, MD, USA.
authors.forename: Marge
authors.initials: M
authors.lastname: Hutchisson
authors.affiliation: Department of Radiology, Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA, USA.
authors.forename: Laurence
authors.initials: L
authors.lastname: Needleman
authors.affiliation: Baptist Cardiac & Vascular Institute, Baptist Hospital of Miami, Miami, FL, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Benenati
authors.affiliation: Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jaff
authors.affiliation: Department of Vascular Surgery, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
authors.forename: George H
authors.initials: GH
authors.lastname: Meier
authors.affiliation: Department of Vascular Surgery, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
authors.forename: Susana
authors.initials: S
authors.lastname: Perese
authors.affiliation: Vascular Laboratory, William Beaumont Hospital, Royal Oak, MI, USA.
authors.forename: Phillip
authors.initials: P
authors.lastname: Bendick
authors.affiliation: Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Hamburg
authors.affiliation: Good Samaritan Outpatient Center, Cincinnati, OH, USA.
authors.forename: Joann M
authors.initials: JM
authors.lastname: Lohr
authors.affiliation: Riverside Radiology Associates, Columbus, OH, USA.
authors.forename: Lucy
authors.initials: L
authors.lastname: LaPerna
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Leers
authors.affiliation: University of Maryland School of Medicine, Vascular Laboratory, Baltimore, MD, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Lilly
authors.affiliation: Wake Forest Baptist Health, Winston-Salem, NC, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Tegeler
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Andrei V
authors.initials: AV
authors.lastname: Alexandrov
authors.affiliation: Intersocietal Accreditation Commission (IAC), Ellicott City, MD, USA.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Katanick
mesh_terms: D000068:Accreditation; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000592:standards / Q000639:trends; D000554:Ambulatory Care Facilities / Q000592:standards*; D016208:Databases, Factual; D003952:Diagnostic Imaging / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D014481:United States; D014652:Vascular Diseases / Q000175:diagnosis*
keywords: Geographic disparities; Intersocietal Accreditation Commission (IAC); Location & Utilization Evaluation (VALUE) Study; Medicare beneficiaries; Vascular Accreditation; Vascular laboratory testing accreditation; Vascular testing