Patient steerage negatively impacts radiology

While the practice of patient steerage--directing patients to low cost providers--has proved to be an effective strategy for insurance companies, its impact on the radiology industry has been less than positive, according to an article in Diagnostic Imaging.

A joint American College of Radiology/Radiology Business Management Association paper published last month points to an informal RMBA survey conducted last year that found that 65 percent of respondents said they were experiencing active steerage by radiology benefit managers, commercial insurers, or both. Active steerage suggests payers are providing patients with incentives, such as gift cards, to choose lower-cost providers. The survey also found that 47 percent of respondents were experiencing "passive" steerage, meaning patients and providers were being provided with cost differential data.

According to Geraldine McGinty, M.D., chair of ACR's Commission on Economics, patient steerage has the potential to impact radiology practices and departments in several ways. First, it could result in productivity losses if, for example, patients are steered toward other practices, leaving behind missed or vacant appointment slots. It also could hurt business--according to the survey, 82 percent of the providers said that patient steerage has decreased their patient volume.

What's more, patient steerage also hurts provider relationships, since many referring physicians have developed relationships with imagers whom they trust will provide high levels of quality and service. Steering patients away from those imaging providers will hurt those relationships and also place a burden on the referring physician by forcing him to forward all existing patient records to the new imager.

Potential liability issues exist, as well, if a patient is steered toward a low-cost imager that was not the first suggestion of the referring physician.

Radiology practices can't control steerage, but there are ways for them to protect their bottom lines, David Levin, M.D., a radiologist with the Center for Research on Utilization of Imaging Services at Thomas Jefferson University, told Diagnostic Imaging. For example, he said, maximizing quality will enable practices to point to the excellent level service they provide in the face of steering challenges.

McGinty added that radiologists need to be more involved with patients and referring physicians so that they understand and appreciate the value they provide.

For more information:
- read the article in Diagnostic Imaging
see the paper from the RBMA and ACR (.pdf)

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