ACOs could have specific effects on radiology departments

The Medicare Shared Savings Program could affect radiology practices through accountable care organization (ACO) enrollment, according to a study by the Harvey L. Nieman Health Policy Institute that was published in the journal Health Care Management Science.

According to a statement, the researchers offered a potential model for radiology departments looking to understand how joining an ACO for CT could influence their business.

Christian Wernz, PhD, of the Nieman Institute said, “Our healthcare system is so complex that it is difficult to foresee the consequences of proposed policies and organizational changes.”

Radiology departments could use the research to evaluate the pros and cons of joining an ACO through CMS (or any other alternative payment model), for their own practices.

The researchers found that enrolling in an ACO made hospitals less likely to invest in new CT equipment, but costs and benefits differed by organization.

According to the statement, “The researchers found that provider participation in ACOs occurs at very different cost benchmarks and physician provider shares vary according to the cost benchmarks set between payers and ACOs. They also learned that the dynamic relationship between provider shares and the cost threshold have important implications on utilization and patient health.”

The Nieman Institute’s Senior Director of Health Policy Research, Danny R. Hughes, PhD, said it could be the number of alternative payment programs that are destabilizing payment structures currently, or it could be that ACOs' inherent incentive structures are causing the “unintended consequences.”

That means administrators would have to carefully consider their departments’ financial situation and how joining an ACO could affect patients, given what Wernz called the “ultimate goal [of finding] ways to improve health outcomes for patients while lowering costs.”