Whitney Palmer

What Bundled Payments Could Mean for Radiology

Published on the Sept. 20, 2011 DiagnosticImaging.com website

By Whitney L.J. Howell

The way you receive reimbursement for your services could soon transform. There are two problems, however: no one is sure to what degree it will change, and radiologists haven’t really had a voice in the conversation.

In line with the Affordable Care Act’s goal of slashing care costs, CMS is studying whether bundled payments, also known as episode-of-care (EOC) payments, can largely replace the fee-for-service model for single illnesses or courses of treatment. As lump-sum payments, EOC reimbursement would tie these payments together with the facility and providers receiving a portion of the total. It’s likely these payments will include most of the imaging procedures done in-hospital.

The testing ground for this model is CMS’s Bundled Payments for Care Improvement Initiative (BPCII). The agency is asking interested hospitals to test four new bundling-payment models and will use feedback to decide which groups of services can be easily moved to EOC payments. For radiology, this is a double-edged sword, said one radiologist who’s studied this topic for the past year.

“The issue here is that bundling could turn imaging from a for-profit center to a cost center,” said Joseph Steele, MD, deputy division head of diagnostic imaging clinical operations at the University of Texas MD Anderson Cancer Center in Houston. “If, under healthcare reform, we’re looking to keep costs under control, there’s a chance fewer tests will be ordered. It’s a 180-degree difference.”

To read the entire article at its original site: http://www.diagnosticimaging.com/healthcare_reform/content/article/113619/1953470

September 21, 2011 - Posted by wjpalmer | Healthcare | bundled payments, Bundled Payments for Care Improvement Initiative, effect of bundled payments on radiology, effect of episode-of-care payments on radiology, EOC, episode-of-care payments, four new models for Medicare reimbursement, Joseph Steele, Naples Radiologists, Pamela Kassing, Paul Dorio, securing payment for radiology under bundled payments, University of Texas MD Anderson Cancer Center