What is the Value of Radiology?

June 6, 2018

Radiologists must better explain their contribution to patient outcomes to gain more freedom.

When it comes to demonstrating the value of radiology, having a seat at the regulatory table is becoming imperative.

Being able to highlight what you bring to patient care is directly linked to whether you participate in the conversations that determine how you practice and what you must report, said Geraldine McGinty, MD, chair of the American College of Radiology’s Board of Chancellors.

At this year’s American Society of Neuroradiology annual meeting in Vancouver, McGinty discussed how the metrics of the various current and impending regulations that most affect radiologists, including the Medicare Access & CHIP Reauthorization Act (MACRA), Merit-based Incentive Payment System (MIPS), and Protecting Access to Medicare Act (PAMA), were developed. And, she emphasized how important it is for specialties to participate in how those decisions are made.

“Radiologists need to get involved. We need to have a voice in the way we need to practice,” she said. “And, we won’t have that voice if people don’t know who we are. It’s a loop.”

In addition to participating in high-level, decision-making conversations, there are other ways for you to showcase the value you bring to the table. For example, clinical decision support (CDS) gives radiologists a unique way to demonstrate their value, McGinty said, because it can side-step mistakes.

“If you’ve done the wrong exam, it won’t matter how well you did it, how nice the patient experience was, or how cost effective you were,” she said. “You did the wrong exam, and it has no value.”

Instead, CDS is radiology’s way of driving appropriate imaging. Using it consistently will become increasingly important when PAMA takes effect in 2020, requiring your referring providers to use a CDS when ordering an exam to ensure your reimbursement.

But technology isn’t the only way you can demonstrate your value. Other institutions, such as Emory University’s radiology department, developed a radiology consult service. By talking to patients and answering their questions, the radiologists both demonstrate and deliver their value routinely.

There are challenges, though, to showcasing the value you provide. And, in some ways, it’s a Catch 22. Many radiologists are held to very high RVU productivity standards and carry heavy administrative loads, so they don’t have the time to spend talking extensively with patients. These responsibilities also make it difficult for many radiologists to get time away from work to attend the specialty conferences where many of these metric decisions are discussed, she said.

Still, it’s important to identify what inspires you as a provider-something that can encourage you to get involved to whatever degree you can. Find a way to offer your insight and expertise on daily practice.

“Be willing to get involved or other people will make decisions about how many cases you must read and what you should be spending your time doing,” McGinty said.

Ultimately, she said, only radiologists know the best ways to maximize the tools and strategies at their fingertips to maximize value and present it to patients, referring providers, and administrators. It’s incumbent upon the industry to share its knowledge.

“At the end of the day, we have, through medical imaging, the power to save lives and change lives to the maximum potential,” she said. “That’s why we went into this specialty. Whatever we can do to get to deliver the care we were trained to do and make as much of an impact as possible, we should do it.”