How one large care network slashed imaging costs by $3M with a simple radiology dashboard

Many health systems are struggling to transition toward value-based care, grappling with ways to improve quality while reducing costs. But one large network has found success using a low-tech radiology dashboard, according to a case study published Friday.

Each month, Duke Primary Care providers—covering eight counties in North Carolina—receive a dashboard with quality and patient satisfaction metrics. But in 2019, the 29-practice organization added radiology utilization data, including provider, practice and network info, researchers explained in JACR

The idea—to have providers compare themselves with peers—worked to a T.

In the first year after implementation, the organization’s median imaging rate dropped by 17.3%, led primarily by behavioral changes in CT ordering. Overall, the project helped Duke cut its imaging costs by more than $3 million in the first year alone.

“Our analysis shows that giving primary care providers transparent, peer-comparison data on imaging utilization can lead to significant and sustained reductions in total imaging costs,” Adrian Clark-Randall, MD, SM, and colleagues with the Durham-based organization explained March 19.

In the two fiscal years before using the imaging dashboard, the group reported radiology costs upward of $13 million annually, driven largely by wide variation in practice patterns, independent of patient characteristics.

Based on radiology orders placed by 159 providers between July 2016 and June 2019, the improvement project dropped CT utilization costs by 34.8%, ultrasound plummeted 21.5%, and MRI costs declined by 16.6%. These figures were based on a retrospective, pre-post analysis using reimbursement data from the Centers for Medicare & Medicaid Services.

Furthermore, 140 of the 159 providers decreased their imaging costs, with an average drop of 20.8%, the authors reported.

Importantly, the study did not assess the appropriateness of imaging exams, so it’s unclear whether their tool led to more high-value testing or influenced outcomes.

And while many physicians were initially skeptical of the project, the authors noted, the relatively cheap tool can also reduce costs in other clinical areas.

“Using this approach to share utilization data may help motivate behavior changes in other clinical settings, including specialty practices, emergency departments, and inpatient facilities,” Clark-Randall and co-authors concluded.

Read the entire study published in the Journal of the American College of Radiology here.

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