How to Succeed at Demonstrating Value for Reimbursement

The following post was contributed by Max Wintermark, MD, clinical adviser of Radiology Support, Communication and Alignment Network (R-SCAN)

EmWinterark_Maxerging health care models are changing the way we make patient care decisions. Whether we practice in a large academic medical center or small rural practices, we must focus on the triple aim of health care reform: simultaneously achieving higher patient satisfaction and care quality, better health outcomes and reduced costs.

 How do we, as radiologists, manage—and succeed—in this cultural shift where reimbursement will be tied directly tied to providing concrete data that demonstrate our role in the delivery of better patient care at lower costs? With the Radiology Support, Communication and Alignment Network (R-SCAN)—a program that creates a collaborative care team of radiologists and referring clinicians to improve imaging utilization, ensuring your patients are at the center of care.

Participating in the free R-SCAN initiative

  • Allows us to collect data that demonstrate radiology’s role in the delivery of better patient care to hospital administrators, payers and accountable care organizations
  • Integrates participation of radiologists, primary care physicians, emergency care physicians and other clinicians who order imaging exams in the continuum of care in outpatient and emergent care settings
  • Focuses on 11 Choosing Wisely® topics — many endorsed by multiple medical societies, having strong potential to achieve improvement in exam ordering
  • Guides us through a clinical improvement activity in three phases typically over a three- to six-month period
  • Provides free access a customized version of the ACR Select™ clinical decision support tool
  • Yields MOC Part 4 and free CME education

Need an example of an R-SCAN project? My colleagues and myself at Stanford are working with our family medicine colleagues to focus on appropriate imaging for low back pain. We gathered baseline data about prescribing patterns using R-SCAN’s dashboard and then designed an appropriate educational program using R-SCAN’s library of suggested options and educational resources. We posted Choosing Wisely-inspired flyers in clinics to explain that imaging does not always help with low back pain and that a scan is not usually recommended as a first step. Now in the post-education stage of the project, we are evaluating prescribing patterns to compare them to baseline data using the R-SCAN dashboard.

R-SCAN is a win-win-win program: Clinicians benefit from an efficient and appropriate image ordering process; radiologists demonstrate value; and patients will get better health outcomes, ideally with less cost.

Want to succeed at demonstrating value for reimbursement? It’s time to participate in R-SCAN. If you’ve registered, what type of initiative are you working on? We can learn from others’ projects.

 Want to learn more? Visit the R-SCAN website. In addition, ACR 2016 — The Crossroads of Radiology® offers the session:  Getting Ready for Value-Based Radiology (R-SCAN).


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