Value-based payment, or VBP, includes both risks and rewards for providers. While VBP requires providers to share financial risk with payers, it also delivers financial rewards for higher-quality, value-based care. With value-based payments, providers receive financial rewards when they meet quality measures, coordinate care, prevent repetitive treatment, control overall costs and improve health outcomes. Despite this financial carrot, value-based payments are on a slow growth path because meeting their requirements necessitates value-based care, which in turn requires access to and sharing of patient data between providers that is frequently not technically possible.
The practice of radiology exemplifies the shift in healthcare delivery required to transition to value-based care. For years, imaging and even imaging informatics has traditionally been siloed from other areas of healthcare and radiology has functioned as a fee-for-service practice. Today, the challenges of changing healthcare economics are breaking down these silos and transitioning imaging to the value-based payment models.
To implement this change, radiologists need to be integrated into care teams. “Having radiologists become a part of the care team—this is what needs to be done to march towards value-based care,” remarks Rasu Shrestha, M.D., chief innovation officer at UPMC.
To become part of a care team and deliver value-based imaging requires efficient and effective tools for accessing and sharing patient data and images, which enables radiologists to contribute to both lower costs and improved care. Examples of patient data that can aid radiologists in their reads includes:
- prior imaging reports
- pertinent EMR information
- lab results
- prior pathology reports and studies
- post-op notes
- discharge summaries
With this additional data, radiologists have insight into whether imaging orders are clinically appropriate as well as additional data for accurately interpreting images. In turn, determining clinical appropriateness decreases duplicate imaging and associated costs and more informed image interpretation delivers better care.
“With a complex cardiac MRI, I want to call the ordering cardiologist to get more information on exactly what is up with this patient. Ideally, it would be great to have the conversation while looking at echo data. And with access to other pieces of information, like the EKG and lab values, we could have an even more meaningful discussion on the patient,” explains Christopher Maroules, MD, a radiologist who specializes in cardiothoracic imaging at the The Naval Medical Center of Portsmouth, VA and also works with Radiology Associates South Florida.
This level of collaboration between radiologists and other patient care team members requires communication technologies that are flexible, efficient and integrated with EMRs. Non-radiologists need tools that enable them to view diagnostic quality images from their EMRs while they communicate with image readers. At the same time, radiologists need access to patient data from their workstations while they communicate with referring providers.
“As we transition our healthcare system from fee-for-service to a more value-based model, these types of tools are going to become more and more attractive,“ adds Maroules.