What is the current economic state of affairs in radiology?
The fee-for-service model, which has been in place for decades, is again being challenged at the federal level. CMS and the federal oversight committees are exploring new payment models such as ACOs to manage the increasing costs of healthcare, and in particular, medical imaging. In the meantime, decreases in traditional reimbursements will challenge the profitability of free standing and hospital based radiology groups.
What information technology tools are most needed by radiology practices to boost their revenue streams and improve efficiency?
In the reduced fee-for-service model, where groups are still paid for services rendered, efficiency is the key. IT solutions that can improve case throughput and optimize radiologist’s efficiency at lower costs will be needed. These include the traditional imaging informatics solutions such as; RIS, PACS, speech recognition, order entry and image distribution. In the risk-sharing model where groups will be paid for their ability to cover lives effectively with quality care regardless of the number of examinations per patient, the technology needs will change. In this era of ACOs, radiology groups will need to be mindful of the overutilization of medical imaging and will need IT solutions to help them with its management. These technologies will include; real-time clinical decision support, bidirectional communication with referring physicians, patient portals and image sharing solutions.
Will the meaningful use program help radiology practices with these challenges? Do the challenges of reporting and qualifying outweigh the benefits?
Think of Meaningful Use as a stepping-stone to capturing the data and creating the monitoring tools necessary for accountable care. MU is on a continuum of payment reform that will lead a group towards ACOs of the future. In a fee-for-service model Meaningful Use appears to plague the radiologist with additional work that is not of financial value (other than the incentives), but in a covered life model meaningful use objectives and the associated clinical quality measures are necessary tools for the radiologist to monitor and manage quality, safety and cost of care.