‘The days of unfettered wholesale imaging are over,’ radiology expert says

Radiologists holding out hope for a return to the days of unchecked imaging studies, with no regard to value for the patient, are more than likely going to be disappointed.

The chief of the Journal of the American College of Radiology recently made that declaration in a new editorial released on Thursday, Dec. 5. As 2020 looms, Ruth Carlos, MD, is surprised to still hear some medical professionals contemplating whether value in medical care is an option. She assures her peers that the train is not returning to the station.

“Value-based imaging is here to stay, Carlos, JACR editor-in-chief and a professor of radiology at the University of Michigan, wrote in the Dec. 5 editorial.

Appropriate use criteria is one of the early tools that may help radiologists cross the threshold into value, she noted. Those first surfaced as part of the Protecting Access to Medicare Act in 2014, with full implementation tied to at-risk payment set to start in January 2021. Education and testing of the criteria—without payments at risk— are expected to start as soon as next month.

JACR will continue to beat the value drum in the coming months, she added. A study in the latest issue of the journal outlines the use of electronic “nudges” to help improve the value of cancer screenings. Plus, their May 2020 issue will explore the appropriateness of different imaging tests for specific clinical conditions, with more value-focused issues to follow.

“The days of unfettered wholesale imaging are over,” Carlos concluded. “What remains is a need for a sensible system to implement measures of appropriateness and value-based reimbursement that assigns the risk of inappropriate utilization to those who have control over ordering decisions. Until then, I have popcorn.”