Radiologist participation in Medicare ACOs is surging, and late comers must take notice

The number of radiologists participating in Medicare accountable care organizations has surged in recent years and those on the sidelines should take notice, according to a new analysis.

Rad involvement in these value-minded care-coordination efforts leapt threefold during the five years ending in 2018, from 10% up to nearly 35%. Participation rates grew faster for physicians in radiology-only rather than multi-specialty groups, experts detailed Wednesday in JACR.

About 87% of large Medicare ACOs (greater than 20,000 beneficiaries) had radiologist participation during that period, and it’s clear the specialty is being recruited into these efforts.

“Over the years, a variety of initiatives have been implemented to more judiciously manage imaging utilization. Radiologists participating in [Medicare Shared Savings Program accountable care organizations] who are incentivized to help manage imaging, however, may have opportunities to be seen as part of solutions rather than problems,” Stefan Santavicca, with the Atlanta-based Georgia Institute of Technology’s School of Economics, and co-authors wrote May 19. “We believe that our work shows that MSSP ACOs are increasingly recruiting radiologists into their plans alongside other specialty care providers, potentially preparing themselves to better assume downside risk in the program while simultaneously improving care and clinical outcomes.”

For the analysis, Santavicca et al. looked to several Medicare data sources to form a full picture of rad ACO involvement between 2013-2018. They found that most larger care organizations had radiologist participation, while medium ACOs (10,000-20,000 beneficiaries) saw a slight gain during the study period, moving from 62.5% up to 66%. Smaller ACOs (under 10,000 Medicare recipients) nearly doubled rad interest, rising from 26% up to nearly 52% by 2018. ACOs with rad participation were typically larger and more diverse in their specialty composition. “Nonparticipating radiologists should prepare accordingly,” the authors advised.

The study did not pinpoint why physicians in imaging are moving toward accountable care en masse. Motivations are likely multifactorial, including wanting to preserve their hospital relationships, avoid challenges with the Merit-Based Incentive Payment System, or feed a desire to participate in utilization management and care coordination.

“Further research on the impact of ACO expansion on imaging utilization and equipment ownership may help radiologists promote greater value as they increasingly participate in MSSP ACOs,” Santavicca and colleagues wrote.

You can read the rest of the study in the Journal of the American College of Radiology here. Emory University, the Hackensack Radiology Group, Triad Radiology Associates and NYU Langone also contributed.

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