HAP Radiology Billing and Coding Blog

The term “Relative Value Units”, or RVU, is used frequently these days in a variety of contexts.  RVUs form the basis for payment of physician fees by Medicare and other payers, and they can be used to measure physician productivity for a variety of purposes.

Healthcare reform is forcing ongoing risk vs. reward debates that seek consensus on the ideal balance of cost expenditure and patient care quality. As a prime example: the issue of if and how to best handle patients with incidental imaging findings receives continued scrutiny. This Reuters article summarizing a recent study in the British Medical Journal (BMJ) highlights the complexities inherent to developing standards of care for the major types of incidentalomas. It also reveals key insights that can be used for the benefit of radiology practices and patients alike.  

Radiologists often identify incidental findings.  When clinically significant, communicating these findings for further evaluation and treatment can be a lifesaving action.  Despite best efforts, documentation in radiology reports does not adhere to a fixed standard, making subsequent analysis of incidental findings quite difficult.  And, while such a finding might be insignificant in the present exam, over time a patient’s status may change and incidental findings may be a key indicator of appropriate follow-up care. 

Converting the US healthcare economy to a value-based model that rewards both quality and cost savings is an objective that still holds bipartisan support, despite the well-known burdens of compliance that many providers have experienced.  While some significant voices are currently advocating repeal and replacement of MIPS, others are for "charging forward". 

If you follow the leading voices in the radiology community, you know that the topic of “value” is a recurring theme of current conversations. It is a core concept behind Imaging 3.0 and has dominated recent seminars, webinars, social media chatter and more for months thanks to MACRA and the many changes it is bringing to provider compensation models. And whatever changes the next wave of governmental healthcare policy washes into the boardrooms of group practices, when the murky waters recede, it is a safe bet that proof-of-value will still remain on the table as a mandate for radiologists going forward. 

The new healthcare economy is redefining many working relationships that have remained unchanged for years. As a prime example, radiologists are understandably concerned about becoming viewed as commodities rather than as physicians who fill a vital role in patient care. One way for them to escape this stereotype is to have more direct interaction with patients, which will also simultaneously achieve one of the goals of the American College of Radiology’s (ACR) Imaging 3.0 initiative – to provide patient-centered, value-based care.