The Radiology Staffing Market, Temporary and Permanent

November 28, 2011 | NONE

Introduction: As pressures on reim- bursement and utilization continue to have an impact on the imaging market- place, radiology-staffing data suggest a shift in the availability and use of pro- fessional services over the past decade. This installment of the Imaging Market File tracks current and recent developments in... Read More »

The 75 Largest Private Radiology Practices

November 28, 2011 | Feature

Introduction During the break of a radiology-group retreat, a young radiologist was congratulating a radiologist 30 years his senior on his upcoming retirement. The young radiologist... Read More »

Radiology’s Nuclear Spring

November 28, 2011 | Adview

Tilting toward RSNA and entering the home stretch of 2011, I haven’t had a lot of time to reflect on the year, but I know that I am not alone. Everywhere I go, I hear a common chorus (no time!) followed by a plaintive refrain (at least I still... Read More »

ACOs: A Concept in Motion

October 28, 2011 | Feature

While health-policy experts debate the potential of accountable-care organizations (ACOs) to address the problem of cost in US health care, a panel held on July 22, 2011, at the RBMA Executive Education Program in Scottsdale, Arizona, reveals that with prototype ACOs already in play and health-care systems assessing their ACO needs,... Read More »

Magical Thinking About Imaging

October 27, 2011 | Adview

I understand that the government does not want to spend money on an imaging examination that is unnecessary. As a fiscal conservative, I have an inherent distaste for waste and actively resent the idea of my tax dollars being spent on anything that isn’t necessary. When it comes... Read More »

UC Davis Medical Center Embarks on Journey to Reduce Dose by 20%

October 21, 2011 | NONE

Dose management (including dose-reduction strategies) is a dominant topic of conversation throughout the imaging world. Cross-disciplinary efforts to resolve the issue are moving to the forefront of both vendor and provider dockets, spurred on not least by quality metrics that tie reimbursement rates to patient outcomes.

At... Read More »

Radiology-group Financial Performance

September 04, 2011 | Feature

Reimbursement pressure, the rising cost of infrastructure, and trends in payor mix are putting continued downward pressure on radiologist compensation.

Introduction: This third installment of the Imaging Market File tracks four key financial-performance measures over time: payor mix, receipts per unit of service, administrative-infrastructure expense, and total... Read More »

ACOs and Radiology Technology: A Conversation With Bibb Allen Jr, MD

July 16, 2011 | Legislative Report

The Patient Protection and Affordable Care Act calls for early adopters to launch accountable-care organization (ACO) demonstration projects and shared-savings programs in 2012. The development of these value-added services and the general trend toward formation of ACOs will undoubtedly lead to changes not only in the acquisition of imaging technology... Read More »

Predator or Prey?

July 16, 2011 | The Big Picture

Here we go again: In a replay of the early, heady days when HMOs and managed-care models blurred the lines between payor and provider, we are again seeing health-care consolidation on a dizzying scale—which is almost obliterating that line completely. Two recent deals are emblematic of both the... Read More »

The 2012 Hit List: Code Pairs That Meet the 75% Threshold

July 04, 2011 | NONE

Radiology first felt the effects of the bundling initiative launched by CMS in 2010, with the creation of combined CPT® codes for myocardial perfusion, wall motion, and ejection fraction (78451–78454); arteriovenous shunt dialysis-catheter procedures, along with radiological supervision and interpretation (36147 and 36148); and facet-joint injection procedures that include imaging guidance (64490–64495).

The Great CT Bundling Heist of 2011

July 04, 2011 | Feature

Medicare is looking for misvalued imaging codes—and it has already found several for which it has reduced payment. Its efforts have dismayed radiologists. Facing more revenue losses from CMS and the private insurers that follow in the agency’s footprints, radiologists feel targeted and, as a specialty, misvalued... Read More »

RBMs in New Orleans: The Panel and the Pain

July 04, 2011 | Priors

On June 7, 2011, at the Annual Summit of the RBMA in New Orleans, Louisiana, four CEOs and one senior leader—representing all five radiology benefit management (RBM) companies—participated in a panel discussion during a general session, “Face to Face With RBM CEOs: Shaping the Dialogue for Imaging’s New... Read More »

The Triple Threat of Bundling Codes

July 04, 2011 | The Bottom Line

Radiology’s existing coding structure is undergoing a dramatic transformation, which is the product of numerous code screens being used by CMS and the RVS Update Committee to identify potentially misvalued services. The application of these code screens often results in the conversion of old codes to new codes.... Read More »

Your Undivided Attention

July 04, 2011 | Adview

The June 2011 MedPAC Report to the Congress1 has the undivided attention of the entire specialty, just days after its release—for good reason. Pages 27 through 59 detail the commission’s recommendations to curtail further the amount of imaging occurring in medicine and to redistribute professional income from image-reading specialties to... Read More »

Clinical Decision Support: The Journey Begins

February 16, 2011 | Feature

Is it goodbye to radiology benefit management (RBM) companies and hello to automated decision-support systems? Not really, as the two aren’t mutually exclusive. Nonetheless, computerized decision-support tools are gaining ground in the outpatient setting.

With CMS about to begin a Medicare decision-support demonstration project for high-end... Read More »

Quo Vadis/ Whither Goest Thou?

February 16, 2011 | Priors

It is no easy task to hit a moving target, so the seven speakers who presented the refresher course, “How Payment Policy Will Impact Technology Development in the 21st Century,” on November 30, 2010, at the annual meeting of the RSNA in Chicago, Illinois, diligently colored in the background of the... Read More »

Where Is the Alignment Behind Decision Support?

February 16, 2011 | The Bottom Line

The lack of consensus (and vision) in the imaging community is readily apparent when the topic of clinical decision support is raised. Clinical decision support allows for electronic documentation of the appropriateness of the imaging service ordered and provided, offering clinicians real-time guidance, rather than black-box rules.

Reimbursement Outlook for 2011: Trouble on the Way

December 12, 2010 | Regulatory Report

On November 30, the Physician Payment and Therapy Relief Act of 2010 was signed into law, delaying the 23% Medicare physician-payment cut mandated by the sustainable growth rate formula. The legislation replaced the cut with a 2.2% update through December 31, with the intention of giving Congress time to find a more permanent solution.... Read More »

New CMS Rules Complicate Supervision and Interpretation

December 12, 2010 | Deal Scan

Recently altered CMS rules governing diagnostic-imaging supervision and interpretation agreements have created what one knowledgeable observer calls a horrible mess. Health-care attorney Tom Greeson, a partner in the law firm Reed Smith LLP of Falls Church, Virginia, expresses concern that regulatory changes that took effect earlier this year might... Read More »

The Sorcerer’s Apprentice: A Conversation With Jeff C. Goldsmith, PhD

November 28, 2010 | Feature

What happens when you cross a futurist and a radiologist?

In October 2010, Oxford University Press published The Sorcerer’s Apprentice: How Medical Imaging Is Changing Health Care, by Bruce J. Hillman, MD, the effective father of the ACR® Imaging Network, and Jeff C. Goldsmith, PhD, a health-care... Read More »

Medicare Imaging Demonstration Project: CMS Rolls the Dice on Decision Support

November 28, 2010 | Feature

Automated decision-support systems to guide physicians who order advanced imaging exams for their patients have been promoted for years, but there have been few implementations. Now, CMS is launching a pilot study to see how well decision support works. It is the first test of decision-support systems applied on... Read More »

The 50 Largest Private Radiology Practices

November 28, 2010 | Feature

Introduction A year ago, I would not have predicted the results... Read More »

The Good-news, Bad-news Economic Scenario

November 28, 2010 | Reimbursment

The list of entities with imaging in their crosshairs goes on and on, but when it comes to eroding reimbursement and enhancing oversight, the current primary culprits are CMS and Congress, according to Maurine Spillman-Dennis, MBA, MPH, director of economics and government relations for the ACR®. In the “ACR... Read More »

A Pollyanna Interlude

November 28, 2010 | Adview

Those who know me even a little would never peg me as a Pollyanna, heroine of the 1913 novel of the same name by Eleanor H. Porter (1868–1920): a cheerful bundle of optimism with the gift of finding sunshine in even the darkest day. Even by those closest to me, I... Read More »

California Dose Legislation: National Implications

November 15, 2010 | Legislative Report

Arnold Schwarzenegger, California’s governor, signed a new radiation patient protection law in October 2010 that mandates strict procedures and reporting requirements for CT scanners and radiation-therapy procedures, as well as the... Read More »