It’s no secret that Radiologists and Radiology practices have been skeptical of Accountable Care Organizations, and who can blame them? One of the touted benefits of ACOs is their ability to reduce costs by way of limiting medical imaging procedures.
Regardless of initial radiology concerns, hospitals and healthcare systems are making plans and taking significant steps toward moving away from the traditional fee-for-service healthcare model and more toward a lower-cost model that places patient outcomes as the top organizational priority, whether it be forming an An Accountable Care Organization (ACO), according to the Centers for Medicare & Medicaid Services (CMS) “is an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who... or connecting to a local health information exchange.
Many radiology department and practices are proactively embracing the change toward accountable care and realize that if they don’t voice their concerns now, their financial futures will truly be left for someone else to decide. Improving communication and beginning an active dialogue with the hospital community are key first steps to securing radiology’s position within the new model.
An article published last month in Diagnostic Imaging, titled “How to Improve Radiology-Hospital Relations — and Why it Matters,” provided great information on how radiology practices can repair relations with referring hospitals. In the article, Cynthia Sherry, MD, chair of Texas Health Dallas Presbyterian Hospital’s radiology department, said the number-one barrier to improving relationships is the breakdown in understanding the expectations of both sides.
The onus to improve relationships doesn’t solely rest with the radiology department, however, and the article says that assigning a radiology department liaison could help open communication channels and broker partnerships that will help when finalizing an ACO relationship.
Another good ACO resource for radiology is the Journal of the American College of Radiology’scomprehensive and well written “A Radiologist’s Primer on Accountable Care Organizations.” The primer provides detailed ACO methods of care and reimbursement, all from a radiologist’s perspective. Much like theDiagnostic Imaging article, the primer advocates for open communication with referring hospitals when planning for ACOs and concluded with the following:
“Radiologists have a lot to contribute, including test selection expertise that is not used often enough and that may have atrophied. …Although strong guidelines may be in place, it is important for radiologists to act as patient advocates to prevent undue restrictions on well-indicated imaging. In addition, radiology must develop a leadership role in research that supports appropriate imaging.”
Further encouragement for radiology to fully participate in ACO discussion came in a CMIO article, titled “AJR: How to stop worrying and love the ACO model.” The article recapped a transcript of a roundtable discussion on ACOs that appeared in the American Journal of Roentgenology (fee required). The CMIO experts on the roundtable emphasized the need of radiologists to emphasize their roles as consultants, not merely interpreters of images – a development that should be welcomed and embraced by radiologists because it has the potential to elevate their expertise within the caregiver team.
Norman J. Beauchamp, Jr., MD, MHS, of the department of radiology at the University of Washington in Seattle, is quoted in the article:
“ACOs reward the radiologist for helping our clinical colleagues understand and embrace the rationale for the imaging recommendations we are providing so that they find our input essential in attaining the common goal of providing patient-centered cost-effective care.”
Regardless of how the Supreme Court rules on the Affordable Care Act, the fact remains that health organizations have invested significant money and time into transforming the way care is provided.
According to the above articles, many radiology departments are taking proactive steps to not only secure needed reimbursement, but also to reaffirm their position as key caregivers with knowledge and tools that consistently improve patient care.Tags: Health Information Exchange, Meaningful Use HiTech