Radiology Partnership Agreements: Achieving Better Alignment Without Hiring the Physicians
While hospital employment of radiologists is less common than in other specialties, there is increasing reliance on this strategy to better align radiologists with health system priorities. Under an employed model, hospital leaders clearly have the leverage they seek to improve care coordination, drive performance improvement or eliminate competitive activities such as imaging center ownership by their radiology group. These potential benefits come at a significant cost though, with financial losses likely in the early years due productivity declines and expenses related to the acquisition and technical integration of the practice. Given the potential negative economic impact of physician employment, it can be advantageous for hospital leaders to focus instead on improving the terms of the existing professional services agreement.
Determine what success will look like
When using the PSA as an instrument for change management, it is important to clearly establish the objectives of the negotiation. These should broadly include promotion of clinical practice that conforms to evidence, along with proactive performance measurement and improvement. Establishing a shared focus on competitive concerns should also be an important outcome. The first task in achieving these goals is to distill the needs into specific metrics that can be easily measured and reported. Once identified, the metrics can then be included in the agreement as a guide for minimum performance thresholds, to structure pay-for-performance incentives, or as a combination of both.
Important quality and operational metrics to include are:
- Interpretive accuracy measured through peer review (error rate)
- Compliance with critical findings reporting policies (reporting time or percent compliance with reporting the diagnoses defined in the policy)
- Interventional radiology outcomes (complication and mortality rates)
- Report turnaround times by location of service
- Percentage of high-tech imaging studies interpreted by subspecialists
The requirements and/or goals for these areas may be formulated by evaluating past performance, benchmarking against external high performers and modeling the expected impact of quality improvement projects and technology upgrades scheduled to take place during the term of the agreement. For example, a hospital planning to eliminate transcription and implement voice recognition should factor in forecasted turnaround time improvements as a result of the change when defining the target in the agreement with its radiologists.
Expect radiologists to lead as well as read
Business development activities are of equal concern to hospitals and radiology groups, and this should be reinforced in the contract. While it is in the self-interest of radiologists to help the hospital gain market share (increased volume is the most effective way to offset declining reimbursement), they can be reluctant to invest significant time in practice-building activities. As accountable care organizations proliferate, the pressure to prevent referral leakage will mount, necessitating involvement by the radiology group in marketing activities. To encourage a high level of engagement in the hospital’s marketing programs, the PSA should incorporate performance standards around volume growth, physician satisfaction and patient satisfaction. Radiologists must own the relationship with referrers, and incentives should promote good habits in this arena.
It should also be the purview of radiologists to educate and evaluate the performance of technologists, define safety policies and assist the department director in improving daily workflow. Similar to practice-building, these activities provide mutual benefit to the hospital and radiology group because improved operational efficiency boosts revenues for everyone. Likewise, increased focus on safety also reduces malpractice liability for both parties. Incorporating key operational and safety oversight requirements in the formal position description for the chairman of radiology is one way to address this contractually with the group.
Use inclusion to achieve buy-in
To increase radiologist commitment to the achievement of hospital objectives, it is essential to give the radiologists a “seat at the table,” enabling them to truly understand and buy into the overall business goals. This may be accomplished through inclusion in hospital committees and participation in discussions about strategic planning, system performance and payer strategy. The challenge is that many radiologists won’t participate willingly in non-revenue producing activities, expecting compensation for time spent on administrative tasks and projects. This stance, while counter-productive, is understandable given recent declines in radiologist income. The problem may be resolved by simply requiring committee participation in the PSA, or in some circumstances it may behoove the hospital to meet the group halfway and provide compensation for time spent on non-clinical activities. While rankling to some administrators, the investment may be worth it, considering how unlikely a disenfranchised doctor is to fully support the mission.
Address health IT needs in the negotiation
Making it easy to do things right serves all parties to the relationship well. The hospital and radiology group should collaborate to select and deploy technology that promotes efficiency and quality, evaluating potential solutions such as voice recognition, radiation dose monitoring or decision support software. It is not enough for the hospital to consult with the radiology group about what to buy; when making technology investments there must also be shared accountability for successful implementation. Decision support software is a case in point. Designed to provide feedback to referrers at the point of order, decision support software in its native form relies on a relatively static matrix of ordering scenarios created by the American College of Radiology in its ACR Appropriateness Criteria®.
While this represents an excellent starting place, some hospitals have concluded that decision support technology isn’t optimal when deployed in a plug-and-play fashion. To get the most out of the system — and avoid backlash from frustrated referring physicians — the content can be configured further (“localized”) to work differently for specialists addressing clinical scenarios not accounted for in the ACR criteria. These types of content changes are necessarily driven by the collaboration between radiologists and hospital clinicians, and implementation of decision support should only be undertaken with commitment from the radiologists to develop the right protocols, educate referrers about the system and manage any referrer concerns. Expectations for participation in any large technology projects should be defined in the PSA to ensure everyone is on the same page about what will be required from the group.
Tie compensation to performance
Determining whether the hospital will continue to supplement the compensation of the group beyond what they bill insurers is another challenging element of the negotiation. Radiology groups have traditionally enjoyed supplemental financial support in the form of stipends, office space, transcription and PACS/RIS, all paid for the hospital. Many contracts have also included hospital payment for preliminary reads during off-hours. Attempts to eliminate stipends and transfer operational costs back to the group will invariably be met with resistance given the downward trajectory of radiologist salaries, although large-scale national radiology groups that eliminate these fees have provided hospitals with more leverage to tackle this issue. Another solution is to re-allocate these dollars to fund the incentive components in the contract; in this approach the group can “earn it back,” but only by delivering the targeted level of performance. The resulting boost in efficiency and volume may ultimately be more lucrative for the hospital than elimination of fees and stipends.
Carrots are one way to change performance, but sticks may also be necessary. For example, what if the hospital agrees to tie incentive compensation to successful implementation of voice recognition but members of the group nearing retirement decide the learning curve is not worth it and simply choose not to do it? Losing incentive compensation may not be enough motivation in a case like this, so the hospital could include a contract provision stipulating that failure to implement voice recognition will obligate the group to employ its own transcriptionists, alleviating the expense for the hospital.
This example highlights an important final principle, which is that in the contracting process, the hospital should always include viable options to deal with non-performance besides the ultimate penalty, non-renewal of the contract. If failure to perform is pervasive, there is ample opportunity to change groups. When considering this solution, leaders must be realistic about the costs involved in terminating the group’s contract, particularly when working it out is an option within reach. In addition to any implementation fees charged by the new group, hospital leaders should also count on costs for IT integration, personnel to manage the project and marketing expenses to promote the new group. When contracting with a large national radiology group, it will be necessary to credential 15-30 radiologists to support a distributed reading model; the resources needed for this should also be factored in. Many hospital leaders find that it is ultimately less disruptive and far more cost-effective to assign some financial penalties to the existing group and then focus together on how to achieve the desired level of performance.
There is no question that negotiation of a comprehensive and highly effective professional services agreement for radiology is both time-consuming and challenging. Given the complexity of issues involved, leaders on both sides must approach the process with equal measures of determination and patience. There will inevitably be areas of disagreement, and those involved in mediating these conflicts should recognize and factor in the value that a strong, mutually beneficial radiology partnership creates in terms of market competitiveness. When done correctly, the rewards of the final agreement are tangible for both sides, enabling the hospital to achieve excellent alignment with their physicians and the radiology group to retain its independence.
Ms. Yates is the founder of Accountable Radiology Advisors, a consulting practice that specializes in advancing the delivery of radiology services. n her previous role she served as the chief quality and risk officer for a national radiology group of more than 150 physicians. Ms. Yates is one of the country’s leading experts on radiology peer review and is a frequent presenter on standardized performance assessment and the transformation from volume-based to value-based reimbursement in radiology. She can be reached via email email@example.com.
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By Kate Madden Yee, AuntMinnie.com staff writer
August 29, 2013
Physician groups that own their own MRI scanners order more studies — but the scans are more often negative when compared with physician groups that don’t own a scanner. The finding could be a sign of overutilization, according to a new study published in the September issue of theAmerican Journal of Roentgenology.
“Self-referral of imaging studies has been singled out as a potentially important factor contributing to rising healthcare costs because, critics assert, financial interest can lead to overutilization,” Amrhein’s group wrote (AJR, September 2013, Vol. 201:3, pp. 605-610).
Studies on self-referral’s effects on imaging use have been criticized for their inability to assess the appropriateness of the exams ordered — a task confounded by factors such as clinical setting, disease prevalence, referral biases, and terminology differences between interpreting radiologists. That’s why Amrhein’s team wanted to assess the rate of normal exams (i.e., negative studies) as well as compare the prevalence and severity of disease within the subject population.
“We set out to test the null hypothesis that no difference in utilization exists between physician groups with self-referred imaging practices and physician groups that do not engage in self-referred imaging,” the team wrote. “To do this, we tested two subordinate hypotheses: There is no difference in the rate of negative MRI scans between self-referred and non-self-referred groups, and there is no difference, among positive scans, in individual lesion prevalence in the two groups.”
For the study, Amrhein’s team reviewed 1,140 consecutive shoulder MRI scans ordered between January and September 2009 by two referring orthopedic groups serving the same geographic community (kept anonymous to protect the identities of the physician groups).
The first group owned the scanners used and received technical fees for their use. The second group did not own the scanners used and had no direct financial interest. The shoulder scans were performed with identical protocols and were interpreted by a single radiologist group without financial interest in the imaging equipment used.
The researchers found that 255 of the 1,140 shoulder MRI scans were negative. The group that owned the scanners had 25.6% more negative scans (142 scans, compared with 113 for the group that did not own the scanners). This result was statistically significant (p = 0.047).
“[Our] data suggest that there may be a lower threshold for shoulder MRI referral in the financially incentivized group compared with physicians with no financial incentive in MRI equipment,” the team wrote.
There was no statistically significant difference in the average number of lesions per positive scan (1.67 for the financially incentivized group and 1.71 for the nonfinancially incentivized group), and there was no statistically significant difference in the frequency of 19 of 20 lesion subtypes.
The fact that there was little difference in the frequency of these lesions is informative, as physicians who self-refer argue their patients are sicker and thus need the immediate access to imaging they provide with their office units, according to study co-author Dr. Ramsey Kilani of Duke University.
“There are probably some scenarios in which that’s true, but it didn’t prove to be so in this study,” Kilani told AuntMinnie.com. “The positive scans showed us that the patient groups were almost identical in their disease — rebutting the argument that the patients that physicians who have MRI scanners see are sicker.”
Although the study does suggest a bias toward increased utilization of shoulder MRI by physicians with a financial interest in the MRI equipment used, it doesn’t prove intended overutilization for profit, Kilani said.
“Doctors that own MRI scanners order significantly more negative scans,” he said. “We’re not making accusations that this is overt, but it is something to investigate.”
The practice of self-referral needs to be examined, according to Kilani.
“Washington has passed across-the-board cuts to curb imaging overuse rather than going after self-referral,” he said. “It’s gotten to the point that outpatient centers are going out of business, and access to imaging is being threatened. The pendulum is swinging too far.”
The self-referral, appropriate use, and pay for quality conundrum
The noise level around health care related to cost seems to be increasing of late, while initiatives to drive interoperability and quality are missing the mark and losing their leaders. Meanwhile, individual hospitals are facing millions in cuts while enduring increasingly invasive payment or RAC audits. The bottom line here was expressed recently by a physician at the AHRA Physician Leadership Day: “Medicine isn’t the problem, it’s the business of medicine.”
We have identified the enemy and it is us
Back before DRGs (Diagnosis-Related Groups) were implemented, around 1982, payments in health care were based on cost reporting and were paid on a “cost plus” methodology. Critical Access Hospitals (“CAH”) still operate this way today, getting paid 101 percent of reasonable costs. Other reimbursement options exist for CAHs, but that’s another article. The DRG system unified the payments based on groupings of services provided. Come in to the ER with a possible heart attack? Medicare has a code that pays one amount, regardless of how many aspirin are consumed. As a result of this payment grouping, providers haven’t paid as close attention to the cost reports any longer. They are still filed, as it’s a requirement, but may not have the same level of attention to accuracy paid to them. As an organization that consults for hospitals, we rarely see an accurate expression of procedural costs.
Fast forward to today. Cost reports are used by Medicare under advice by groups such as theRUC (Specialty Society Relative Value Scale Update Committee) to adjust Medicare reimbursement. To be fair, that description is a gross oversimplification of the effort and information utilized. But what is important to know is this: The cost reports, as explained recently by one member of the RUC, while variable between submitter, indicate a low cost to deliver things like medical imaging that is not representative of true costs.
So if Medicare and its advisers are using the cost reports, among other things, to help determine reimbursement, and the reports show a steady or declining cost, it might make sense then that Medicare is reducing reimbursement. Have we missed something along the way?
Your credit line has been exceeded
The sustainable growth rate (SGR) originally created in 1997 to help limit spending from Medicare for physician services has been exceeded every year since 2002. The fix was intended to be what are called “negative updates”, which means reduced reimbursement. But for the last ten years Congress has passed a series of short term fixes (kicking the can down the road) to prevent these cuts from happening. So today the estimated cost to fix the disparity between the original SGR formula from 2002 and where Medicare spending is now is estimated by the Congressional Budget Office to be significantly more than $140 billion. Yes that is a “B”. While the House Energy and Commerce committee voted 51-0 to repeal or fix the SGR on July 31, 2013, no plan has been developed to pay for this fix…yet. If a fix is not in place by the end of 2013, physicians who treat Medicare beneficiaries will see cuts estimated at 25 percent. If history is any indication, expect the can to be kicked again. What we really need is a solution. Most physicians today don’t have a profit margin of 25 percent. Without a fix or a kick of the can, this is unsustainable.
Free beer tomorrow…
…said the sign in the restaurant. Sound familiar when you think about health reform and the changes since it passed in 2010? Transparency cried the masses! We need transparency through access to data to determine what is really going on! Yet, call a Medicare Administrative Contractor (“MAC”) and ask for de-identified utilization data. Click… buzz is what you will hear. Call Medicare directly and ask the same. After several hoops you can get a 5 percent file. That is one in 20 claims; hardly representative and impossible to determine who is referring what to whom with statistical certainty. HIPAA rules aren’t making it any easier. The problem is, in order to get to real automated clinical decision support, we need access to the linear patient records, including outcomes. Another way to think about “pre-encounter” clinical decision support is predictive healthcare. Using the scads of data already available in the hundreds of millions of patient records to analyze treatment and outcome patterns would clearly reveal what works and what does not.
Solving the riddle
Self-referral (of diagnostic testing services) is a complex issue and is driven by several factors. Some legitimate, like proximity to the testing services; other self-referral excuses perhaps not so legitimate. Self-referral, the growing use of diagnostic testing services in general and the increasing cost to payers, including Medicare, are the primary engines behind the cry for appropriate use. Then, in no small part due to the efforts of some clever statisticians who quantified broad gaps in patient outcomes compared to costs in several markets across the country, the light came on flashing “Pay for Performance” (“P4P”) not just for doing the work. Quality in other words. Perhaps you see now how wise the statement was in our first paragraph: “Medicine is not the problem, it the business of Medicine”. Any business with a poor quality product (Inappropriate use, poor outcomes, high cost) will not last long. Not everyone is on board with pay for performance as a recent study by the JAMA published by Diagnostic Imaging found 70 percent of 2556 respondents not in support of eliminating fee-for-service. However, that same study revealed 89 percent believe they need to take a more prominent role in limiting the use of unnecessary tests.
To get to appropriate use, which drives quality and keeps cost down, we must first completely understand our current care models and outcomes, to determine what changes must be made to improve. The caveat is: you cannot improve what you cannot measure. The HITECH Act is paying providers (Meaningful Use) to report on key measures while no structure or incentive exists to capitalize on and learn from the data now being collected. Providers are being paid to simply report on collecting basic data. It’s a wonderful start but there is no process or plan that we know of, to actually learn from the data. Larger than that is the lack of interoperability between information systems in health care which, by the way, is driving some of the duplication of services, waste, and cost through a lack of access to complete patient histories between providers.
Without a standard for collecting and communicating longitudinal patient records for analysis, learning and feedback, it’s going to be tough to learn from the data. Compounding the problem is a lack of a national patient identifier and a well-founded concern for protecting health information.
To drive pre-encounter clinical decision support based on actual patient outcomes, to propel appropriate use; to minimize cost and maximize positive patient outcomes, we need to connect patient data nationally and learn from it to make decisions. It’s a simple concept, a feedback loop.
Feedback loops, sometimes thought of as Artificial Intelligence, by design, learn from themselves by constantly evolving and adjusting, using historical and new data, as defined by the analytics design, to deliver actionable measures. This technology is no longer Star Trek fiction – it exists today. These approaches can allow the bi-directional connection of health IT systems and deliver the advanced automated analytics clinicians can use to make decisions based on accepted criteria. The result is appropriate tests (bring down cost) that reveal the answers to the clinical questions (based on past and current results) that direct clinicians to treat for the best (proven through data) outcomes. The new outcomes feed back into the data because health care data are standardized and connected. Sound like a circular reference?
Boldly go where no one has gone before; (to) live long and prosper
Disruptive innovation, we are told, is innovation that creates new markets and value networks. Do the goals of the Affordable Care Act (“ACA”) represent a corollary? If the ACA is promoting P4P, the fundamental problem of measuring our performance today must first be solved. To get there the measurement capability must be able to quantify the thousands of elements needed to determine quality and performance through the measurement of thousands of outcomes, not simply attesting that the data is being collected. It’s time health care boldly solves its own issues following in the footsteps of other dominant industries to demand standardization and communication of health care-related data. Then we must make ourselves and our vendors accountable.
Based in Franklin, Tennessee, Regents Health Resources is a national consulting firm focused on the complexities of medical imaging. As President of Regents, Brian concentrates on business strategy and development focused on industry challenges.
The engaging radiologist
CT scans rise fourfold in EDs, but hospitalizations fall by half
A new look at a decade’s worth of emergency visits suggests increased use of CTs may help physicians send patients home sooner.
If Radiology is accountable for quality imaging, then the provider should be equally accountable to follow the radiologist’s recommendations. Assume for a moment that Radiology is black box. There’s the ‘order’ and the ‘result’.
In an ACR Select enabled imaging world, consultations are performed when it matters. Radiologists and ordering physicians regularly communicate. Imaging shares in the reward of creating impact in the continuum of care for selecting the right order and disseminating an actionable, track-able report such that all parties are held accountable to the guidance.
Accountability matters, and, it’s a two way street. A few simple additions to the reporting workflow bring quality alive.
Actionable Reporting is an important next step in the implementation of Appropriate Imaging. The concept is simple. Close the loop! Make your findings and recommendations measurable.
Make your reports “actionable”. One way is include a structured finding and recommendation code with each report. For example:
- Is the finding consistent with the reason the exam was ordered?
- Is the recommendation for more imaging a result of the wrong exam being ordered?
- Is there an incidentialoma (sic)? If so, what’s the severity? Is it critical?
Ensure the provider is held equally accountable:
- Was the exam really the right one opposite the selected reasons for exam?
- Were the reasons for exam “right”?
- It’s also possible that there was a better exam opposite the conditions, and that’s worth knowing, recording and acting on.
- Was there a prior exam that would have dis-intermediated this exam?
- Are your recommendations, (which was requested as a result of the ordered exam) being followed? If not, why?
Often, radiologists work with no clinical correlation for the advice they are giving. Producing an actionable, track-able report is the starting point for demonstrating the radiologist’s value in the care continuum.
Jeffrey Singer: The Man Who Was Treated for $17,000 Less
Bypassing his third-party payer, my patient avoided a high hospital ‘list price.’
Every so often I have an extraordinary and surprising experience with a patient—the kind that makes us both say, “Wow, we’ve learned something from this.” One such moment occurred recently.
A gentleman in his early 60s came in with a rather routine hernia in his lower abdomen, one that is easily repaired with a simple outpatient surgical procedure. We scheduled the surgery at a nearby hospital.
My patient is self-employed and owns a low-cost “indemnity” type of health insurance policy. It has no provider-network requirements or preferred-hospital requirements. The patient can go anywhere. The policy pays up to a fixed amount for doctor and hospital bills based upon the diagnosis. This affordable health-insurance policy made a lot of sense to this man, based on his health and financial situation.
When the man arrived at the hospital for surgery, the admitting clerk reviewed the terms of his policy and estimated the amount of his bill that would be paid by insurance. She asked him to pay his estimated portion in advance. (More hospitals are doing that now because too often patients don’t pay their portions of the bills after insurance has paid.)
The insurance policy, the clerk said, would pay up to $2,500 for the surgeon—more than enough—and up to $2,500 for the hospital’s charges for the operating room, nursing, recovery room, etc. The estimated hospital charge was $23,000. She asked him to pay roughly $20,000 upfront to cover the estimated balance.
My patient was stunned. I received a call from the admitting clerk informing me that he wanted to cancel the surgery, and explaining why. After speaking to the man alone and learning the nature of his insurance policy, I realized I was not bound by any “preferred provider” contractual arrangements and knew we had a solution.
I explained that just because he had health insurance didn’t mean he had to use it in every situation. After all, when people have a minor fender-bender, they often settle it privately rather than file an insurance claim. Because of the nature of this man’s policy, he could do the same thing for his medical procedure. However, had I been bound by a preferred-provider contract or by Medicare, I wouldn’t have been able to enlighten him.
Hospitals and other providers make their “list” prices as high as possible when negotiating contracts with health plans and Medicare regulators. No one is ever expected to pay the list price. Anybody who has seen an “Explanation of Benefits” statement from a health plan will note a very high charge from the provider, and an “adjusted charge” based upon the contracted fee schedule, which usually leaves the patient with little or nothing in out-of-pocket expenses. The only people routinely faced with list prices are those few people who have insurance like my patient’s—that doesn’t include a pre-negotiated fee schedule with contracted providers—or those who have no insurance.
Most people are unaware that if they don’t use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the “list” price. Doctors are happy to do this. We get paid promptly, without paying office staff to wade through the insurance-payment morass.
So we canceled the surgery and started the scheduling process all over again, this time classifying my patient as a “self-pay” (or uninsured) patient. I quoted him a reasonable upfront cash price, as did the anesthesiologist. We contacted a different hospital and they quoted him a reasonable upfront cash price for the outpatient surgical/nursing services. He underwent his operation the very next day, with a total bill of just a little over $3,000, including doctor and hospital fees. He ended up saving $17,000 by not using insurance
This process taught us a few things. First, most people these days don’t have health “insurance.” They have prepaid health plans. They pay premiums to take advantage of a pre-negotiated fee schedule arranged for and administered by a third party. My patient, on the other hand, had insurance.
Second, even with the markdown for upfront “cash-pay” patients, none of the providers was losing money on my patient. Otherwise they wouldn’t have agreed to the prices. With the third-party payer taken out of the picture, we got a better idea of the market prices for the services. It is the third-party payment system that interferes with true price competition, so “market clearing prices” can’t develop.
Take the examples of Lasik eye surgery or cosmetic surgery. These services are not covered by insurance. Providers compete on the basis of quality, outcomes and price. And prices have continually dropped as quality and services have improved—unlike the rest of health care.
When my patient returned for his post-op visit we discussed the experience. It was clear to both of us that the only way to make health care more affordable is to diminish the role of third-party payers. Let consumers and providers interact through market forces to drive down prices and drive up quality, like we do when we buy groceries, clothing, cars, computers, etc. Drop the focus on prepaid health plans and return to the days of real health insurance—that covers major, unforeseen events, leaving the everyday expenses to the consumer—just like auto and homeowners’ insurance.
Sadly, we are heading in the exact opposite direction. ObamaCare expands the role of the third party and practically eliminates the role—and the say—of the patient in the delivery of health care. Will they ever learn?
Dr. Singer practices general surgery in Phoenix, Ariz., and is an adjunct scholar at the Cato Institute.
A version of this article appeared August 22, 2013, on page A15 in the U.S. edition of The Wall Street Journal, with the headline: The Man Who Was Treated for $17,000 Less.
The entire payment model for healthcare services is transforming towards rewarding the value of care and Radiology is not immune.
In today’s payment models the net unit value of imaging is dropping. Although Imaging has unquestionable value in the delivery of healthcare, the amount providers and payers are willing to pay for imaging is most certainly being questioned.
The Radiologist role in the care cycle for patients is well beyond the reading room. But how can Radiologists be held accountable for inappropriate utilization of value imaging resources without a seat in the vehicle.
ACR Select is an integral part of Radiology’s roadmap to value based care. A National Standard, maintained by the American College of Radiology. Key word: Radiology.
Structured indications at the point of order ensure that orders are based on valid and defensible medical reasons.
Every order is scored; every order gets a unique Decision Support Number. This data is the basis for a true understanding of the pain points that are creating inappropriate utilization and the positive impact of quality imaging.
Appropriateness Scoring during order entry drives consultation for questionable orders, prevent in appropriate exams and foster real time learning and interaction with the ordering physician. Helping to increase visibility and relevance.
With ACR Select, Radiology has the opportunity to manage towards value based payment contracting for Imaging Services, by ensuring quality/compliance, and, sharing in the subsequent total savings.
With ACR Select, Radiology can reposition the value of imaging in the value chain and highlight the system wide impact of imaging:
- Cognitive, consultative
- Impact on the entire care continuum
- Imaging saves cost
Re-establish the obvious. Appropriate Imaging improves patient care and saves costs.
- Proper consultation and the resulting appropriate exam and properly communicated result reduces length of stay and readmission rate
- Managing authorizations through third parties creates overhead and complexity. ACR Select creates simplicity and transparency. Allowing physicians to focus on paient care vs. navigating authorization workflows.
- ACR Select creates a transparent platform for all stakeholders in the process to share data and align on outcomes
Get on the road. Take the steering wheel. ACR Select creates a platform for new models for Radiology Service delivery where the impact of quality Radiology service has on the patient care cycle is quantified, and obvious. Radiologists can get paid for value by sharing in the total impact and helping it’s customers manage outcomes in risk bearing models.