“It makes sense to target imaging and radiology because some are discretionary services,” said Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins Bloomberg School of Public Health. “It's part of the large picture of looking at everything that clinicians do and making sure there is not overuse.”
Radiologists have become increasingly concerned about the status of their roles within bundled or capitated payment models as well as whether new payment policies may limit patient access to testing.
These factors led the American College of Radiology to last year establish the Harvey L. Neiman Health Policy Institute, which plans to fund and conduct research on imaging utilization.
“There's a widespread belief—and I think it's currently inaccurate and based on dated material—that medical imaging is leading the way in our very expensive healthcare system and its rising costs,” said Dr. Richard Duszak Jr., the organization's CEO and senior research fellow.
The Neiman Health Policy Institute last week proposed a classification system that would separate repeat medical imaging into four categories: supplementary, duplicate, follow-up, and unrelated. “Studies and policy remedies that seek to examine repeat testing for potential efficiencies may produce unintended consequences for overall quality of care if researchers and policymakers do not carefully consider the clinical context of a particular text—a problem that is only confounded by ongoing use of ambiguous terminology,” according to the institute's report.
In addition, the institute plans to pay up to $60,000 each for projects that target the value of imaging, the role of radiologists in alternative healthcare models, the relationship between imaging and quality, and the impact of new payment models on patient access, practice ownership and utilization.
“Our intended primary target for this, because we're really getting to the core of a developing body of research in repeat testing, is to help improve the level of thoughtful conversation among health services researchers and the policymakers that then will be making payment or coverage or other determinations based upon that research,” Duszak said. “Our goal is not to say that radiology should be paid more, or imaging should be done more.”