Curbing costs by reforming healthcare is the goal behind the Affordable Care Act also known as Obamacare. Doctors and healthcare facilities are already bracing for change especially in the way they are reimbursed for services.
According to a recent article in Diagnostic Imaging, radiology is an area of medicine that has been reimbursed for decades under the fee-for-service model. This model is an unbundled payment system that pays for services individually and one that has been criticized for driving up overall healthcare costs.
Now radiologists and imaging centers are preparing for a new payment model under
Obamacare which will require them to demonstrate value in their services. This
group knows going forward it will be paid differently for different services and some are worried about being able to pay their bills.
The value modifier program currently applied to primary care services is also being
considered for radiology. Under this program, beginning in 2015, practitioners
in groups of more than 100 eligible providers are required to submit their 2013
performance data through a physician quality reporting system (PQRS).
Some radiology groups are adopting a gain sharing reimbursement strategy. If the
practice reaches a target set for selected imaging services, it receives a portion of the savings earned by the insurance provider.
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