ACOs Could Mean Greater Radiology Role in Patient Care

Radiologists could have a greater role in patient care through Accountable Care Organizations (ACOs), but now’s the time to get involved, according to consultant Claudia Murray, president of CMC LLC.

“It would give radiology a voice in that patient continuum of care,” Murray said, speaking at an RSNA 2011 session Sunday. “That would be beneficial in many ways for the patients.”

ACOs, a healthcare reform model that ties reimbursements to quality metrics through a group of coordinated providers that are accountable for the costs and share in the savings, could mean improved communication and transparency of patient information - and a greater involvement by radiologists, she said. But there are a lot of questions around the model and a lot of issues to consider, and to secure that greater involvement, radiologists need to be heard now.

“For radiologists to be involved, they have to decide now and get to the table to negotiate. They need to demonstrate that they add value,” Murray said.

Demonstrating that value could be fairly easy in many ways, because the radiology industry is familiar with the quality reporting and IT infrastructure that the ACOs will rely on. In many ways, she said, radiology is far more prepared than the primary care, particularly those practices just starting to adopt electronic health records.

“We need to know how to manage the risk, the cost, the scope of the service - but we have the tools to do that,” Murray said. “We can really help affect making sure the patient gets the right study at the right setting at the right prices.”

Imaging represents a large percentage of costs for patient care, which means it’s been targeted for reductions. However, radiologists must make a case for managing that imaging, and thus sharing in the savings intended with the ACO model.

That’s not going to be easy, and moving to an ACO model has many challenges, Murray noted. Although the model aims to lower cost and improve patient care, it’s such a different approach. Among the challenges facing radiologists in an ACO world is the need to shift the culture to one that’s more collaborative across specialties and less apt to fight over who gets what piece of the shared savings pie.

The ACO rules will continue to evolve, Murray noted, and radiologists need to actively participate in the discussion on a national level, as well as in the formation of an ACO.