JACR® May Highlights
High-Deductible Health Plans Pose Challenges to Radiologists
Patients with high-deductible health plans have been shown to have different habits of healthcare access, including delaying necessary care due to out-of-pocket costs. They may also be more likely to search for details on out-of-pocket expenses before electing to pursue specific treatments or exams. However, obtaining pricing information is challenging, and information patients are able to obtain is frequently incomplete, difficult to understand, or outright incorrect. This also poses a challenge for radiologists who may attempt to communicate accurate out-of-pocket pricing information to patients. Several strategies are suggested for managing this problem. The first is to direct patients to their health insurance, as copays can vary dramatically based on insurance provider and specific plan. Some radiology practices have lowered their chargemaster prices and published that information in highly visible places such as their websites, newspapers, etc. Perhaps the most effective step is to have the proper tools to inform the patient directly what their costs will be at the time of inquiry. Generally this requires third-party software programs that may not always be available.
Analysis of Malpractice Claims Involving Diagnostic and Interventional Neuroradiology
Most radiologists will be involved in a malpractice claim at some point in their careers. As the scope of radiology practice continues to expand, radiologists are more exposed than ever. A retrospective investigation of VerdictSearch’s legal claims database provides some insight into the outcomes of litigation involving neuroimaging and neuro-interventional procedures. A total of 126 cases were analyzed. Forty-one percent of the cases listed irreversible brain damage as a complication, while 32 percent listed paralysis, and 27 percent listed death. Forty-four percent of the cases resulted in a defendant ruling, 25 percent in a plaintiff ruling, 26 percent in a settlement and five percent in a mixed decision. Plaintiff awards varied widely, ranging from $50,000 – $45,000,000. Mean settlement amount was $1,950,000.
The Cost of Uncertainty: A Patient’s Perspective
The patient experience is fraught with uncertainty, anxiety, and incomplete information. This is not limited just to their diagnosis or potential medical outcomes, but extends to their expenses, logistics of making it to their appointments, and strain on their families. Patients don’t expect physicians to have all the answers, but navigating the healthcare system remains a daunting task. As radiologists, we should take advantage of opportunities to help offer clarity for the next step of a patient’s medical journey.
The FDA and AI in Radiology: Defining New Boundaries
The healthcare AI market is growing dramatically, with a predicted tenfold increase in market size from 2014 to 2021. Regulatory guidelines governing the implementation and use of these technologies must adapt rapidly to keep pace. The FDA recently introduced new programs to approve software products in the healthcare realm. These include the Digital Health Software Precertification program, which allows certified developers to bring “lower risk” products to market without full premarket review. Additionally, this allows for small changes to be made to a product or device without requiring full resubmission. There is some controversy surrounding this approach, given that it requires vetting of organizations rather than individual products, raising questions about both the safety of this approach and the authority of the FDA to undertake such a review. As radiologists, we must be familiar with the approaches used to evaluate the safety and efficacy of AI programs and work closely with government organizations to ensure optimal patient outcomes when using new medical technologies.