The American College of Radiology is expressing concern that a new proposed quality metric from the Centers for Medicare & Medicaid Services would pose too much burden for hospitals.

CMS first announced the change in April as part of the 2024 Inpatient Prospective Payment System rule. The agency is proposing a new electronic clinical quality measure for inpatients tied to “Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography in Adults.”

The college said it agrees with efforts to increase patient safety in the radiology department.

“However, we strongly recommend that CMS take a considered approach to implementing the Excessive Radiation Dose measure into the [Inpatient Quality Reporting] program, allowing a period for larger-scale testing and experience with the measure before attaching stricter requirements impacting hospitals providing services under the IPPS,” ACR CEO William T. Thorwarth Jr., MD, wrote in comments submitted on June 9.

The agency proposes to adopt the measure into the IQR and the Medicare Promoting Interoperability programs starting with 2025 calendar year reporting period. But ACR is concerned the change would require “considerable organizational efforts” to access and process the data required to calculate a provider’s score. Such complexity would force hospitals to either create software or buy a commercial product to track this information, ACR noted.

“Regardless of in-house or commercial solutions, hospital staff who are likely already juggling multiple technological priorities, software upgrades, transitions or installations will be tasked with implementing the proposed measure,” Thorwarth wrote.

ACR cited other concerns with the measure, including the methodology to calculate it, validity and possible unintended consequences. Leaders are asking CMS to work with the imaging community to devise an approach that addresses the proposal’s shortfalls.

“Although the ACR has outlined various concerns with the proposed measure, we are aligned with its goal,” the comments concluded. “We seek to work in partnership with this stakeholder community and CMS to identify and implement measures addressing radiation dose and safety that are methodologically and scientifically sound, provide meaningful feedback and improvement opportunities, have transparent data collection and calculation methods, and are as least burdensome as possible.”