Long-Term Commitment

Radiologists nationwide breathe life into Imaging 3.0™.long term commitment

Imaging 3.0™ was launched at the 2013 AMCLC as a way for radiologists to demonstrate their value in the new health-care world. Now, five months later, where are we in telling and living this important story?

Will Imaging 3.0 be like "New Coke" (an ill-fated rebranding in the late 80s) and fizzle quickly, or will it fundamentally change the way we as radiologists present ourselves to the health-care community and, most important, to our patients? I am happy to report that ACR's members have embraced the challenge and — despite the obstacles — the momentum of Imaging 3.0 is building.

Over the past five months, the Imaging 3.0 team has been engaged in conversation with radiologists around the country to understand how they are making the changes that Imaging 3.0 requires. Laurie E. Gianturco, MD, chair of radiology at Baystate Medical Center in Massachusetts, pledged a strong commitment to this "opportunity for radiologists to redefine their value," as she described it. But with primary care in the driver's seat and patients increasingly acting as payers and demanding transparent pricing, Gianturco knows that she and her radiology colleagues need to be at the table when decisions are being made within their ACO. Passionate about the benefits of decision support, Gianturco has had to confront the issue of providers with multiple, different electronic health record (EHR) platforms and competition from national radiology companies, but she remains optimistic about the future.

The Imaging 3.0 website contains some inspiring stories of how and where change is happening, and I encourage you to visit http://bit.ly/Imaging3CaseStudies.

Decision support has been a key part of the Imaging 3.0 toolkit and an early success story was that of the Institute for Clinical Systems Improvement (ICSI), a non-profit quality-improvement organization in Minnesota that serves more than 50 medical groups and hospitals. ICSI piloted decision support with 4,500 providers, most of whom liked the software enough that they continued to use it after the pilot ended. Since the launch of the pilot, decision support is estimated to have saved Minnesota's health-care system $150 million. You can read the whole story at http://bit.ly/MinnesotaImg3.

The innovative use of IT tools will be a key driver of success for Imaging 3.0. In the June issue of the ACR Bulletin, Mark D. Alson, MD, FACR, president of Sierra Imaging Associates in Fresno, Calif., faced his own group's challenges with referrers on varied EHR platforms. (Read "Fortresses with Moats," at http://bit.ly/FortressesMoats.) Alson engaged the IT experts at the College, but equally as important, he started a communication outreach effort with the practice's referring physicians to ensure that his group remains a preferred imaging provider.

The often anxiety-producing tectonic shifts in health-care delivery and payment are creating some exciting opportunities for radiologists. In Arkansas, the Healthcare Payment Improvement Initiative, a collaboration between Medicaid, the Arkansas Department of Human Services, and two of the state's largest private payers (Arkansas Blue Cross Blue Shield and Arkansas Qualchoice), is committed to doing things differently when it comes to reducing costs. The emphasis is on a collaborative approach, which James E. McDonald, MD, vice chair of radiology and director of the Division of Nuclear Medicine at the University of Arkansas for Medical Sciences in Little Rock, Ark., sees as a "tremendous opportunity for radiologists to distinguish themselves as true partners for referring physicians." The full story can be found at http://bit.ly/BendCostCurve.

The key to ensuring the lasting success of this initiative will, of course, be making sure that Imaging 3.0 is valued in the health-care payment system. As of press time, the Sustainable Growth Rate repeal bill (HR 2810) included a requirement for the Secretary of Health and Human Services to provide a report to Congress on the benefits of decision support. (Read the bill at http://bit.ly/HR2810SGR.) The bill does not go perhaps as far as we would have liked, but it is a good start. The Metrics Committee of the Quality and Safety Commission continues to work on the development of a physician quality reporting system and other measures that recognize and reward quality imaging providers.

The continued drastic cuts to imaging services proposed by CMS for 2014 are a huge obstacle to change, and the College has opposed them vigorously. You can read our HOPPS comment letters at http://bit.ly/HOPPS and our MPFS comment letter at http://bit.ly/MPFS-ACR. We also continue to meet with the executive leadership at CMS to urge them to work collaboratively with radiologists to leverage the power of what we can contribute to high-value care. All of us who are struggling to maintain the level of excellence that our patients deserve while coping with these cascading cuts know how hard it can be to think about doing things differently — especially when you are not sure you can make the payments on your equipment. The Economics Department at the ACR is committed to advocating for fair reimbursement for the services we all provide, both in the fee-for-service system under which most of us operate currently and within the payment models of the future.

We would love to hear your own stories about Imaging 3.0. You can contact me at This email address is being protected from spambots. You need JavaScript enabled to view it. and follow me on Twitter at @DrGMcGinty.

mcGintyBy Geraldine B. McGinty, MD, MBA, FACR, Chair

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