$319 billion. That’s how much could be saved on healthcare costs if the government acted on Blue Cross and Blue Shield Association’s (BCBSA) recent recommendations.
The problem: medical imaging would get squeezed.
BCBSA’s recommendations follow a by-now familiar pattern: 1) Replace fee-for-service reimbursement with outcome-based reimbursement, 2) Invest in primary care, and 3) Invest in preventative care.
The details, however, bring out the trouble for medical imaging. The recommendations use a partnership between Wellmark Blue Cross Blue Shield and a radiology benefit management company as a model. The partnership relied on prior authorization from the benefit management to reduce the use of medical imaging.









