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George Wiley

What policymakers and payors want from radiology departments is not volume, but value. If radiologists can help hospitals contain costs, improve quality, and increase market share, then these radiology providers will be well positioned to carry their hospitals—and themselves—into the era of quality- and performance-based pay.

Today’s radiology dashboards let you know how your department or practice is running. They chart patient flow; report-turnaround times; critical-results reporting; and dozens of other data points that reflect cost, efficiency, productivity, and (sometimes) effectiveness. One of the primary goals of these dashboards is to support quality improvement, as CMS and other payors begin to link payment to performance—and to define performance using quality measurements.

Standardization in radiology can take a dozen different paths, and it is clearly complex—but why is there a need for standardization in the first place? Debra L. Monticciolo, MD, FACR, is vice chair for research at Scott & White Healthcare (Temple, Texas), a nonprofit health system. She is a professor of radiology at the allied Texas A&M Health Science Center College of Medicine and is a subspecialist in mammography. Monticciolo is chair of the ACR® Commission on Quality and Safety. Of course, quality and safety are among the primary reasons that standardization is a talking point for so many who hold stakes in radiology’s future.

In the 1990s, it was easy to be a success. You had to work hard not to be a success. That’s not true any more,” according to Michael P. Recht, MD, Louis Marx professor of radiology at New York University School of Medicine and chair of the radiology department at NYU Langone Medical Center (New York, New York).

The deftness of data movement between sites creates a deception that it’s easy; it’s not. Leaving aside technical problems with integration, servers, and storage, the more central problem might be this: Who pays the bill to set image exchange in motion?

After a six-month period of collecting baseline data, the CMS Medicare Imaging Demonstration began on April 1, 2012. The imaging industry is watching this test closely. If the two-year demonstration shows that a computerized decision-support system can guide referring physicians to make appropriate orders for advanced imaging tests—and, at the same

Buy a banana, and it will cost you less than a dollar per pound—unless you’re in a hotel, where it might cost you twice the grocery-store price. The prices of many items readily obtainable by the consumer usually fall within a well-defined range, according to supply and demand. This is not so in health care (in general) and in medical imaging

It is a well-accepted axiom in business that to be successful, a leader must want to lead. The truth, though, is that business entities often struggle to find leaders because no one really wants to put in the time or make the effort to push the organization up the hill.

Radiology might become the first medical specialty to face Medicare’s mythical death panel. If the specialty keeps taking hits, it might die, critics of proposed Medicare reimbursement cuts warn. The death-panel idea began as a political slur, meant to tar advocates of expense reduction for end-of-life care. As it turns out, in the current budget

Medicare is looking for misvalued imaging codes—and it has already found several for which it has reduced payment. Its efforts have dismayed radiologists. Facing more revenue losses from CMS and the private insurers that follow in the agency’s footprints, radiologists feel targeted and, as a specialty, misvalued themselves.