Healthcare Economics: The dismal science?
An understanding of the economic factors driving the radiology business has become a prerequisite to the successful practice. It’s a broad and complex term that covers business basics; politics; regulations, rules and reimbursement; leadership; and more.
After a long wait and much debate, the Centers for Medicare & Medicaid Services (CMS) released the final accountable care organization (ACO) rule Oct. 17. Most providers and healthcare organizations met the final rule with a sign of relief as it opened the door to potentially larger incentives while also relaxing quality measures.
Indeed, participants in a recent American Journal of Roentgenology roundtable discussion urged radiologists to stop worrying and love the ACO model, noting that it could expand radiologists’ role and value.
“In the ACO model, the radiologist can bring value by playing the central role in ensuring that the appropriate imaging study is performed to address the clinical question as well as by ensuring that a study is not performed when it will not impact the clinical management of the patient,” wrote Norman J. Beauchamp, Jr., MD, of the department of radiology at the University of Washington in Seattle. "ACOs reward the radiologist for helping our clinical colleagues understand and embrace the rationale for the imaging recommendations we are providing so that they find our input essential in attaining the common goal of providing patient-centered cost-effective care."
Another hot button issue is meaningful use, which has been an uphill climb for radiologists. Requirements geared to primary care providers make it somewhat difficult for radiologists to qualify for incentives. But they do qualify for individual incentives of $44,000 annually and aggregate incentives of up to $1.5 billion. It is a complex, and evolving, process.
For the latest updates and lessons from pioneers, be sure to check out a refresher course dedicated to meaningful use or healthcare reform.
Other keys issue on the radar range from commoditization and competition to teleradiology and demographics. Professional leadership and recognition also have bubbled to the surface in recent years, with societies and experts exhorting to take a leadership role.
Be sure to find time for one or two healthcare economics sessions and check out live show coverage on Health Imaging. I can’t predict the final economic impact of these various factors, but I’m comfortable promising that healthcare economics will be neither dismal nor dull.
Lisa Fratt, editor