The Year in Review: Acquisitions, standards, and value

There’s been a lot of big business news in the imaging world this year, including historic business deals, new headline-grabbing standards, and the continued trend of reimbursements being tied to value.

Acquisitions

The world of radiology saw a lot of mergers and acquisitions in 2015, from smaller facilities joining forces to major powerhouses continuing to grow larger and larger. One of the biggest deals of the year, first announced in August, was IBM’s $1 billion acquisition of Merge Healthcare. IBM made the move in order to help improve the intelligence of its Watson Health Unit.

“Healthcare will be one of IBM's biggest growth areas over the next 10 years, which is why  we are making a major investment to drive industry transformation and to facilitate a higher quality of care," John Kelly, senior vice president, IBM Research and Solutions Portfolio, said at the time.

RadiologyBusiness.com ran a Q&A with IBM’s Kyu Rhee shortly after the deal was announced.

“What’s great about Watson is it continues to learn and it continues to improve, so I think there’s extraordinary opportunity in addressing the challenges in health and healthcare around cost, quality, experience and engagement,” Rhee said. “Those are four key areas where I believe we’ll have a significant impact in health and health care.”

The deal was finalized in October.

New standards

For those most interested in significant policy decisions, 2015 may be viewed as the year of tracking the latest United States Preventive Services Task Force (USPSTF) draft breast cancer screening recommendations and rushing to fully comply with the new XR-29-2013 CT standard.

The USPSTF draft breast cancer screening recommendations were first announced back in April, giving biennial mammograms for women ages 50 to 74 a “B” grade.

The Affordable Care Act mandates that payors cover tests that receive a “B” grade or higher from the USPSTF; those receiving a “C”—including mammograms for women ages 40 to 49 or annual mammograms for women ages 50 to 74—could potentially not be covered by insurers.

“Many insurers may try to use these recommendations as an excuse to not cover women for mammograms,” Barbara Monsees, MD, chair of the American College of Radiology (ACR) breast imaging commission, told RadiologyBusiness.com at the time. “State programs are an area that deserves close watching. In addition, if insurers don’t pay for mammograms with no co-pay, the cost can be a barrier for lower income women.”

The ACR, Society of Breast Imaging (SBI), GOP Doctors Caucus, and Senator Barbara Mikulski (D-MD) were just some of the voices to express dissatisfaction with the USPSTF recommendations.

“We know that early detection of breast cancer offers women their very best chance at a cure and at survival,” Mikulski wrote in her letter. “Mammograms are essential for that early detection.”

Physicians, including Jennifer S. Haas, MD, division of general internal medicine and primary care at Brigham and Women’s Hospital in Boston, showed support  of the recommendations as well.

“USPSTF recommendations are based on the current evidence,” Haas told RadiologyBusiness.com back in July. “Unfortunately, evidence accrues slowly. I think that is the reason that politicians and advocates have tried to use legislation to bypass this. But the unfortunate reality is that care that isn’t evidence-based may result in unintended adverse consequences (overdiagnosis, overuse of tests) that can have a negative impact both for individuals and society.”

In addition to these various opinions, an original infographic from over the summer showed how the recommendations are influencing surgeons.

Even in late December, this story is still being told. Just last week, the Protecting Access to Lifesaving Screenings (PALS) Act, which would create a two-year moratorium on implementation of the U.S. Preventive Services Task Force (USPSTF) draft recommendations on breast cancer screening, was included in a $1.1 trillion spending bill passed by Congress.

XR-29, also known as Smart Dose CT, was the other big policy change in 2015, though there were others as well. A summary from October summarizes a lot of information about this new standard.

Beginning on Jan. 1, 2016, there will be a 5 percent reduction in Medicare Part B payments for CT scans performed on noncompliant equipment. The following year, that payment reduction jumps to 15 percent.

Demonstrating value

As healthcare continues to evolve, reimbursements are being tied less to the quantity of services carried out and more to the quality of those services. “Value” is the name of the game for radiologists now, and it’s up to healthcare providers to learn for themselves how best to demonstrate the value of what they do on a daily basis.

Richard Duszak, MD, chief medical officer of the ACR’s Harvey L. Neiman Health Policy Institute, covered this topic in detail during his keynote presentation at the AHRA 2015 Virtual Fall Conference.

“If we don’t define our value in medical imaging, somebody else is going to do it for us,” Duszak said during the presentation. “It’ll be your CFO, your COO, the new radiology group that replaces your existing radiology group, or the administrator that replaces your job moving forward.”

In addition, Phuong-Anh T. Duong, MD, of the Emory University department of radiology and imaging sciences, and colleagues wrote about various ways radiologists can demonstrate value in a two-part report for Academic Radiology.

Those are just a handful of some of the biggest stories RadiologyBusiness.com covered in 2015.

What sort of business news will impact radiology in 2016 and beyond? Only time will tell.