Preoperative Testing

What is Preoperative Testing?

Prior to surgeries, providers often order preop tests to identify clinically significant concerns. This may include tests such as blood work, electrocardiograms, or chest x-rays. However, research evidence shows that preoperative testing, especially prior to low-risk, outpatient surgical procedures, often provides no clinical benefits and may even cause harm. Despite this, these services continue to be ordered at unnecessary rates.

MVC’s preoperative testing value-based improvement initiative helps increase the rate of patients receiving appropriate preoperative testing in Michigan by giving providers tools to improve, peer learning opportunities, utilization data, and pay-for-performance incentives.

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False alarms from preoperative tests can delay surgeries, creating additional burdens for patients and surgeons.
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Preoperative testing can lead to a treatment cascade if non-significant abnormal results are detected. These additional tests or invasive procedures may cause real patient harm.
Preoperative testing is estimated to cost the United States $18 billion annually, and preoperative payments totaled over $3.7 million in Michigan in 2018 according to MVC claims data.

MVC recently partnered with MPrOVE, MSQC, and ASPIRE to establish RITE-Size, an initiative working to help hospitals reduce low-value preoperative testing before low-risk, elective procedures.

RESOURCES

Cover sheet graphic reading RITE-Size Decision Aid & Preop Testing Chart

RITE-Size Decision Aid & Preop Testing Chart

Available for download:

View the [PDF] Version & [Word] Version

Cover sheet graphic reading RITE-Size Primary Care Physician Package

RITE-Size Primary Care Physician Package

Available for download:

View the [PDF] Version & [Word] Version

Screenshot from first page of a report titled "Preoperative Testing Report - BCBSM Payers - Hospital A" with two caterpillar plots and one trend graph

MVC Preoperative Testing Blinded Report

MVC developed preoperative testing reporting to evaluate testing rates across the state of Michigan for three low-risk procedures. These data are available to members and RITE-Size partners via MVC push reports, custom reports, and registry pages.