Radiologists must be proactive when it comes to accountable care

Over the past several weeks the Affordable Care Act has been at the forefront of political arguments over budgets and debt ceilings, and we should be reminded that it is a law that certainly will have a continuing impact on radiology.

In an article in this week's issue of FierceMedicalImaging, some observers of the radiology industry point out that with the transition to an environment of accountable and cost-efficient care, academic radiology departments will have to stop focusing on volume and instead concentrate on providing value.

In fact, the shift toward different payment models demands that all radiologists will have to start proving their value. But when it comes to payment structures--like bundled payments and accountable care organizations--how will it be decided how radiologists will fare in a shared savings set-up? Consequently, the challenge will be demonstrating the value that radiologists bring to patients and medical associations.

They should be able to do so in a number of ways, particularly when it comes to the issue of imaging appropriateness. There will be an ongoing drive to reduce imaging utilization by eliminating unnecessary imaging, and radiologists should be a central part of that process. After all, who knows more about imaging than radiologists? Whether it's providing research on clinical decision tools or consulting closely with referring physicians on imaging appropriateness, radiologists have a critical role to play here.

There are other ways radiologists can provide value, as well. They have been healthcare industry leaders when it comes to working with information technology, and should be prepared to leverage that advantage when it comes to adapting to this new healthcare environment. Technology, no doubt, will be foundational to providing accountable care to patients.

And, as imaging leaders such as Richard Gunderman have long argued, radiologists should be more willing to engage directly with referring physicians and, in particular, patients. Last year Gunderman and Peter Miller performed a study at the University of Indiana in which they determined that only about half of the patients who underwent a CT exam actually knew that radiologists were physicians. That certainly must change.

By engaging in practices like improving communication with patients and referring physicians or taking the lead on imaging appropriateness, radiologists should be able to demonstrate that value, and more. The key, though, will be taking a proactive approach. - Mike  @FierceHealthIT

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