The Value of Radiology Services in Value-Based Care

By | October 29, 2020

Radiology services play an essential role in value-based care. Yet, some believe that such services fall into the category of cost; however, if we change our perspective, we can consider such activities may elevate the overall value we deliver. In fact, diagnostic radiology can have a clinical benefit because it can help to refine differential diagnoses, define and decrease the time needed for treatment, which can result in decreasing morbidity and mortality. However, there are basic principles that must occur within the practice of radiology in order to elevate the overall value.

For radiology to enhance value, such services must serve to improve patient outcomes and quality of life. Thus, additional research is needed to better understand its impact. Ordering practitioners, for the most part, are not responsible for the costs incurred. But, this scenario creates a financial disconnect; thus, value-based payment models that include radiology services are critical for focusing on quality and affordability. Furthermore, it’s crucial to realize that underutilization of a particular service may lead to inadequate care. And overutilization may increase care costs.

In enhanced models of care, the provider of radiology services must actively ensure that the use of radiologic investigations is justified, appropriate, and evidenced-based. Furthermore, they are accountable for accurate “readings,” information, and proper communication with ordering professionals to obtain relevant clinical information and reporting results. Therefore, radiologists and their staff are an integral part of a value-based care team and not merely a provider of services. Hence, in value-based payment models, it’s vital to include them in risk-based models as well as the network’s ongoing improvement initiatives.

It is important to note that ordering clinicians do not always have the most updated understanding of appropriate diagnostic studies, the value of each for a specific condition or the relative cost of one compared to another. But, radiologic providers have such knowledge, thus bringing high value to the conversation. Furthermore, coordination with clinical professionals is necessary concerning the contextual information required for correct test decision-making thus improving the diagnostic outcomes, because reading a film with no clinical information lessens the value of the interpretation.

As with all care delivery, radiologists can maintain a culture of constant quality improvement, including determining who is the best person to provide a specific service? With technology’s progression, distributing the appropriate information and studies to the subject matter expert is greatly enhanced. Additionally, artificial intelligence or machine learning has the potential to elevate the accuracy even more.

We must view radiology and radiologists as critical components of delivering value-based care and include in value-based payment models. As viewing such services as a “cost” undermines our ability to elevate care while controlling spending. Let us work together to incorporate all our opportunities to deliver needed services to those we serve.