ACA impact on radiology to be large, but not immediate

The Affordable Care Act will have a large, yet gradual, effect on the radiology industry, according to a talk presented during the recent Virtual Symposium on Radiation Safety and Computed Tomography.

Andrew Bindman, a professor of medicine, health policy, epidemiology and biostatistics at the University of California San Francisco, talked specifically about radiology's role under new payment models that encourage more cost-effective and accountable care, according to

"Under the ACO model, one could start to anticipate that radiology becomes more of a cost center than a revenue generator," Bindman said. "That raises important issues about the need for a business model for consultations that don't result in as many tests being ordered, particularly those that are less important or less necessary."

Consequently, Bindman said, ACOs will be looking to make radiology exams as cost effective as possible, which means more research will be necessary on the appropriateness of imaging and its impact on outcomes. To that end, he talked about projects taking place in Chicago and Detroit that are promoting the use of decision support to determine the appropriateness of imaging before exams take place.

The transition from a fee-for-service system that rewards volume to one that rewards value should result, Bindman said, in payers being more amenable to reimbursing radiologists for safe and appropriate imaging.

In forecasting the role of imaging under healthcare reform in 2015, Franklin, Tenn.-based imaging consulting firm Regents Health Resources predicted that imaging use would increase 13.6 percent nationally, despite the continued downward pressure on reimbursement for the technical component of outpatient imaging. The five states predicted to see the biggest jump in utilization were Texas, New Mexico, Georgia, Nevada and California. 

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