The move from fee-for-service reimbursement to a relative value unit (RVU) based compensation model represents a seismic shift for medical imaging clinicians. The notion of incentivizing behaviors may rub radiologists the wrong way. But a team approach to disseminating radiology information may provide a solid rationale for delivering quality care and meeting the demands of a new payment system.
A value-based environment encompasses “… a whole new way of managing labor and compensation, distributing work and valuing efficiency,” said Marcia C. Javitt, MD, radiologist at Walter Reed National Military Medical Center in Washington, D.C., in a recent MolecularImaging article.
With a flexible and transparent radiology information system, physicians can use clinical and performance data from a dashboard, monitor metrics and modify and reward predefined activities. The team concept extends beyond compensation and includes quality metrics for patient outcomes, Javitt’s added.
Quantifying performance measures like community service, collaboration and patient satisfaction is an area where hospital thought leaders and radiology groups are just now moving toward. Deciding what metrics to measure will differ from medical center to medical center, but those outcomes must be factored into the front end of any radiology information system.
Once historical patient data is entered, such as length of stay or surgical results, analyzing population-based patient data can be used to guide medical imaging orders. “In other words, it’s the concrete implementation of evidence-based medicine,” said Javitt.
“If radiology practices wait until the new rules are implemented, there will be a learning curve to implement the desired behavior. We should incentivize it now,” says Richard Duszak, Jr., MD, CEO of the Harvey L. Neiman Health Policy Institute in Reston, Va., which was created by the American College of Radiology to study the role of radiology information systems in evolving healthcare delivery and payment systems.
Reuben Mezrich, MD, PhD, professor and former chair of diagnostic radiology and nuclear medicine at The University of Maryland School of Medicine in Baltimore, offers a more immediate rationale for alternate metrics. It’s not uncommon for radiologists to suffer from tunnel vision and get so busy focusing on image review and report generation that they forget about their real job—clinical consultation.
A holistic, performance-based compensation system that recognizes and rewards collaborative behavior can incentivize more radiologists to prioritize service and respond to a team approach.
Are you seeing a shift to more transparency and collaboration in your radiology department?