Caving to provider concern, CMS announced yesterday that it would implement end-to-end ICD-10 testing this summer for “a small sample group” of providers.

In a comment letter on the final 2014 Medicare fee schedule for physicians, the ACR pointed out once more the cumulative effect on imaging reimbursement of various recent legislative and policy changes and urged CMS to adopt a “dampening” policy to limit the total amount a specific procedural code could be reduced in a given year.

The Garden State becomes the 14th state that requires mammography providers to include breast density status in reports sent to patients.

On September 9, 2013, Cheryl Proval, editor, Radiology Business Journal, moderated “The Boston Experience: Radiology’s Value Proposition in the New Health-care Paradigm,” a panel discussion held in Boston, Massachusetts, at the RBMA Fall Educational Conference.  The meeting location offered a unique opportunity to explore radiology’s changing value proposition under health-care reform with a panel that represents hospital-based radiology, outpatient radiology, and the payor community.

Efficiency can be thought of as the volume of work done over a period of time. In diagnostic radiology, that has been interpreted to mean RVUs per radiologist per unit of time. With decreasing per-case reimbursement, we have seen particularly strong pressures to increase efficiency. Unfortunately, some practices have done so at the expense of other important functions.

Eight years ago, I sent an email to Barry Pressman, MD, FACR, radiology chair at Cedars-Sinai Medical Center (West Hollywood, California). My 75–year-old mother, a lifelong nonsmoker whose primary-care physician had diagnosed lung cancer (based on a chest radiograph), needed a referral to a surgeon. Pressman recommended Robert McKenna, MD, who had helped pioneer video-assisted thoracic (VAT) surgery in this country.

As health care moves from fee-for-service to value-based medicine, and, eventually, to population health management, imaging is facing the imperative to redefine its role in the care continuum. “We’ll be focused closely on value and outcome measures in the environment we’re calling imaging 3.0,” says Mike Tilkin, CIO of the American College of Radiology (ACR). “Radiologists will play pivotal roles throughout the care process—from the time a study is ordered to being engaged as a consultant throughout the care cycle to being a resource to the patient.”

On July 16, 2013, CMS announced the results¹ of its accountable-care organization (ACO) program, the Pioneer ACO Model. The program was designed to test the impact of higher levels of shared savings and risk on ACO success, and it attracted 32 participants from around the country. After the first year of participation, seven Pioneer ACOs that did not produce shared savings announced their intention to transition to the lower-risk (and lower-reward) Medicare Shared Savings Program, while two dropped out of the ACO model entirely.