DMBN: For new technologies, a lot of people think another big hurdle, especially in radiology, will be comparative effectiveness. Do you see this being a really big player in the next couple of years for Medicare reimbursement, or FDA approval, really wanting scientific evidence showing actual clinical benefits on even small advancements in technologies?

Sorensen: The trend is clear, whether or not health care reform on the federal level passes the Supreme Court. The trend in insurance companies is already moving toward value-based reimbursement. Not fully - we're still very much a fee-for-service reimbursement model in the United States. But unmistakably, there's a trend toward value-based reimbursement. How does that affect what we do? In some ways it makes it easier. If you are no longer focused on the dollar you're getting for an X-ray but rather on what the outcome is, then you're free to say, "Well, does this newer X-ray machine help me?" And when it does, you can make that decision instantly. And so, I think that we're not afraid of that process, because we think our tools are valuable.

DMBN: I guess the complexity argument changes - because now the total cost of health care is what you have to gauge.

Sorensen: It is a more complex argument, and it's harder to tease apart that whole value chain. Traditionally that's why we've avoided it - because so many things happen therapeutically between the diagnosis and the outcome. Did they respond to the treatment? Was the treatment administered well? Was it appropriate for that patient, etc.? And we, as imagers, diagnosticians, don't really control that, so it's unfair to penalize or reward us for those successes. But that era is over, unfortunately. We can't really hide behind that anymore. That requires new thinking on our part. We have to think about how to fit into that value chain.

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