A special report in the Journal of the American College of Radiology examines the role radiology plays in a much-talked about payment model in the Affordable Care Act: Accountable Care Organizations (ACOs).

Study authors see ACOs as the long-awaited catalyst to the profession's chance to assert its leadership.

"Looking back at the last 10-15 years, radiologists have felt increasingly marginalized and there have been market forces that have caused it to be perceived as an exchanged commodity," Dr. Richard Abramson, one of the paper's authors and assistant professor of radiology at Vanderbilt University School of Medicine, told DOTmed News.

But ACOs, which financially reward physicians who work together to decrease costs and preserve quality of care, could help radiology define itself in a new era of medicine that's shifting toward value-based care.

In the paper, authors point to four different components of a "system service line" that radiology could highlight as sources of value: Decision support, or playing a more active consultative role; IT leadership; quality and safety assurance; and operations enhancement.

Abramson said radiology is well positioned to provide leadership in an ACO model because of it's long history with primary care and specialty positions, as well as what the professions have done innovating around information technology.

"There's going to be a certain combination of clinical, technical and operational expertise to promote the initiatives that will make ACOs successful," he said.

Several ACOs are up and running. According to the last estimate by the U.S. Department of Health and Human Services this summer, there are roughly 150 ACOs in the U.S. And while there are opportunities for imaging within the ACO model, Abramson said radiologists have not been involved as far as he can tell. "Part of that [reason] is that ACOs are growing out of primary care groups," he said.

Additionally, there are no guidelines on how Medicare ACOs should be set up. The only direction the federal government gives involves how payment would be structured. According to Abramson, initially it's a fee-for-service model with opportunity for shared savings later on. "Then they basically get a rebate," he said. "There will be headbutting about dividing up shared savings."

When radiologists do become more involved in ACOs — as is the hope — Abramson said the last piece of the puzzle will be figuring out how to measure their value. "We're going to have to think about how to do that."

Back to HCB News

More Industry Headlines