Striving for Value-Driven Radiology

Moreton Lecturer encourages a leadership stance on reduction.Striving for Value Driven Radiology

This year, the much-anticipated Moreton Lecture featured James L. Reinertsen, MD, founder of the independent health-care consulting and teaching practice The Reinertsen Group, who presented "Possible or Passible? Setting Aims for Accountable Health Care." He began by identifying volume as a key driver of any health system's financial success — "especially the volume of high-margin services such as imaging," he said.


Reinertsen reported that U.S. health-care costs are much higher than other countries, in part due to the amount spent on physician fees. "Policy-makers here in Washington, D.C., have taken notice of this [spending discrepancy]," he added. As a result, "The principal driver of health-care policy for the next decade with be cost reduction."

These cost-reducing measures are evident in radiology in the form of Radiology Business Management companies, the Sustainable Growth Rate, and Multiple Procedure Payment Reduction, among many other initiatives. Yet Reinertsen also cited the ACR Appropriateness Criteria® as a positive example of how decision support can reduce costs.

So, how can radiologists prepare for a radiology compensation system that drives value, not volume? Reinertsen proposed three choices to audience members. First, individuals will need to decide whether to take a leadership stance on this issue. Second, he urged members to realize the strategic opportunity for communities to "come together systematically to prevent complications and reduce overused services." This clinical integration may not come easily; it will necessitate changes in what Reinertsen called the Four Fs: Form, Finance, Function, and Feeling. And members will need to decide if they want to implement this clinical integration on their own or have it done for them. Finally, Reinertsen highlighted a third choice for radiologists: settle for the passable or reach for the possible. The passable is defined as adequate, or "what's good enough," he explained. But the possible aims higher. For example, a passable goal for a legislator might be to get re-elected, whereas a possible goal would be to make history in his or her career. Reinertsen further explained how a rock climber accomplishes the possible by stretching for a reach stone, or "a hand hole you cannot see." And as with most choices, "There's a risk involved," he concluded. Reinertsen challenged ACR members to aim higher, reduce costs, and prioritize a value-driven business model. Read more about the Moreton Lecture in the April ACR Bulletin at


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