Position your practice for success in the transition to value-based care. Learn how American College of Radiology Appropriateness Criteria supports Choosing Wisely recommendations to help reduce unnecessary tests and procedures.
News & Insights
Ahead of the Curve: Early adopters of CDS deliver more appropriate imaging and help ordering physicians prepare for PAMA’s impact on reimbursement.
When the radiology team at Einstein Healthcare Network in Philadelphia, Pa., first heard about the Protecting Access to Medicare Act (PAMA) of 2014 , which requires providers to consult clinical decision support (CDS) for advanced image ordering, they had an uncommon response: Bring it on!
At the time, Einstein’s chair of diagnostic radiology, Terence A. S. Matalon, MD, FACR, FSIR, was already evaluating the merits of CDS to enhance patient care at the network’s three hospitals and 11 outpatient centers. The legislation further bolstered these efforts.
“Dr. Matalon started thinking about CDS before the PAMA legislation was even on the radar,” says Ryan K. Lee, MD, MBA, section chief of neuroradiology at Einstein. “He thought it might be useful for our referring clinicians, and he became a driving force behind our rollout of evidence-based technology.”
A Better Way: ePA and Beyond
An AMA video guide to the advantages of ePA and how your organization can start using it.
Survey: Patient Clinical Outcomes Shortchanged by Prior Authorization
CHICAGO – More than nine in 10 physicians (92 percent) say that prior authorizations programs have a negative impact on patient clinical outcomes, according to a new physician survey released today by the American Medical Association (AMA). The survey results further bolster a growing recognition across the entire health sector that prior authorization programs must be reformed.
“Under prior authorization programs, health insurance companies make it harder to prescribe an increasing number of medications or medical services until the treating doctor has submitted documentation justifying the recommended treatment,” said AMA Chair-elect Jack Resneck Jr., M.D. “In practice, insurers eventually authorize most requests, but the process can be a lengthy administrative nightmare of recurring paperwork, multiple phone calls and bureaucratic battles that can delay or disrupt a patient’s access to vital care. In my own practice, insurers are now requiring prior authorization even for generic medications, which has exponentially increased the daily paperwork burden.”
ACR Case Study: Engaging the Physician
Sometimes the best patient care involves no imaging at all. So when the radiologists at Baylor College of Medicine noticed that some referring physicians were ordering more MRIs for low back pain than seemed appropriate, they took the lead to study the situation and deploy a solution for improved patient care.
In doing so, the radiologists turned to the ACR’s Radiology Support, Communication, and Alignment Network (R-SCAN™), an innovative quality improvement initiative that brings radiologists and referring clinicians together to enhance image ordering and reduce unnecessary imaging.
Change Healthcare Acquires National Decision Support Company
NEWTON, Mass., Jan. 18, 2018 /PRNewswire/ — Today Change Healthcare announced the acquisition of National Decision Support Company (NDSC), a leader in cloud-based solutions that deliver medical guidelines to the point of care through leading electronic health record (EHR) systems. The addition of NDSC accelerates the efforts of Change Healthcare to leverage evidence-based clinical information and next-generation technologies to reduce cost and help ensure appropriate care.
