The Reading Room

Our latest update on all things imaging

Price transparency can lead to lower costs, even for those patients who do not shop

by Matt Morrill and Ty Aderhold February 12, 2019

Are patients actually shopping for imaging? Here at the Imaging Performance Partnership, we have been seeing this question more and more of late. While estimates assert that 30% to 40% of health care, including most medical imaging, is shoppable, studies continue to show that patients are not shopping for imaging care as much as one might expect.

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How incidental findings management may have saved Justice Ginsburg's life—and what that means for your imaging department

by Matt Morrill and Emily Snow January 29, 2019

Back in November, 85-year-old U.S. Supreme Court Justice Ruth Bader Ginsburg was hospitalized with three fractured ribs due to a fall. While a concerning injury, it may have actually been a blessing in disguise.

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The top 5 questions on site-neutral payments for imaging in 2019, answered

by Matt Morrill and Ty Aderhold December 20, 2018

In 2017, CMS implemented a site-neutral payment provision to reduce payment discrepancies between identical services performed at hospital outpatient departments (HOPDs) and provider-based sites.

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Imaging CDS begins in 2020: Get the 6 latest updates

by Erin Lane and Catherine Kosse December 4, 2018

Editor's note: This post is out-of-date. Click here to get our latest update, published on Aug. 27, 2019.

Earlier this month, CMS released the Medicare Physician Fee Schedule (MPFS) final rule for calendar year 2019. For imaging, many of the biggest updates concern the imaging clinical decision support (CDS) mandate, also known as the Medicare Appropriate Use Criteria (AUC) Program.

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How Medicare's final rules affect imaging in 2019

by Erin Lane, Catherine Kosse, and Ty Aderhold November 12, 2018

Last week, CMS released final rules governing hospital outpatient facility and provider payments  for calendar year (CY) 2019. The rules outline major payment and regulatory updates for radiology, including changes to site-neutral payments and clinical decision support policies.

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How a new study on inappropriate imaging orders should inform your strategy to curb unnecessary testing

by Matt Morrill and Ty Aderhold November 6, 2018

One billion dollars per year—that's how much one study estimates is spent on neuroimaging for headaches in the United States, an exam that is considered low value by Choosing Wisely. Considering that imaging for headache is just one of many Choosing Wisely targets related to imaging, it's clear that reducing unnecessary imaging could significantly affect overall health care spending. However, although the Choosing Wisely campaign launched over six years ago to help reduce unnecessary, low-value medical services, studies have found it's had only limited impact on imaging utilization to date.

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Scrutiny over hospital imaging prices continues: How you should respond to UHC's new policy

by Lea Halim, Matt Morrill, and Catherine Kosse October 23, 2018

UnitedHealthcare (UHC)*, the ­­­­­largest commercial insurance company in the United States, announced a new site-of-care policy for MR and CT procedures conducted in hospital outpatient departments (HOPD). Effective January 1, 2019, the payer will conduct site-of-care reviews for these exams during the prior authorization process. UHC explained this policy furthers their commitment to the Triple Aim of reducing health care prices, improving services, and generating quality outcomes.

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Lung cancer screening works. But how can we increase compliance?

by Matt Morrill and Ty Aderhold October 16, 2018

Lung cancer screening has a significant impact on mortality rates for high-risk individuals, according to the results of a large randomized trial, NELSON, presented at the World Conference on Lung Cancer. The 10-year study found that low-dose CT screening decreased lung cancer mortality by as much as 61% in at-risk women, with a smaller—yet still significant—decrease of 26% for high-risk men.

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