title: Report of the ACR's Economics Committee on Value-Based Payment Models.
abstract: A major outcome of the current health care reform process is the move away from unrestricted fee-for-service payment models toward those that are based on the delivery of better patient value and outcomes. The authors' purpose, therefore, is to critically evaluate and define those components of the overall imaging enterprise that deliver meaningful value to both patients and referrers and to determine how these components might be measured and quantified. These metrics might then be used to lobby providers and payers for sustainable payment solutions for radiologists and radiology services. The authors evaluated radiology operations and services using the framework of the imaging value chain, which divides radiology service into a number of discrete value-added activities, which ultimately deliver the primary product, most often the actionable report for diagnostic imaging or an effective outcome for interventional radiology. These value activities include scheduling and imaging appropriateness and stewardship, patient preparation, protocol design, modality operations, reporting, report communication, and clinical follow-up (eg, mammography reminder letters). Two further categories are hospital or health care organization citizenship and examination outcome. Each is discussed in turn, with specific activities highlighted.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: gboland@partners.org.
authors.forename: Giles W
authors.initials: GW
authors.lastname: Boland
authors.affiliation: Department of Radiology, Virginia Mason Medical Center, Seattle, Washington.
authors.forename: Lucille
authors.initials: L
authors.lastname: Glenn
authors.affiliation: Department of Radiology, Icahn School of Medicine, Mt Sinai Hospital, New York, New York.
authors.forename: Shlomit
authors.initials: S
authors.lastname: Goldberg-Stein
authors.affiliation: Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Jha
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Mark
authors.initials: M
authors.lastname: Mangano
authors.affiliation: Department of Radiology Elkhart General Hospital, Elkhart, Indiana.
authors.forename: Samir
authors.initials: S
authors.lastname: Patel
authors.affiliation: Radiology Associates of North Texas, Fort Worth, Texas.
authors.forename: Kurt A
authors.initials: KA
authors.lastname: Schoppe
authors.affiliation: Department of Radiology, Sutter Health, Sacramento, California.
authors.forename: David
authors.initials: D
authors.lastname: Seidenwurm
authors.affiliation: Department of Radiology, University of Kansas School of Medicine, Wichita, Kansas.
authors.forename: John
authors.initials: J
authors.lastname: Lohnes
authors.affiliation: South Texas Radiology Group, San Antonio, Texas.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Silva
authors.affiliation: Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Richard
authors.initials: R
authors.lastname: Abramson
authors.affiliation: Department of Radiology, Lifebridge Health, Baltimore, Maryland.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Durand
authors.affiliation: American College of Radiology, Reston, Virginia.
authors.forename: Laura
authors.initials: L
authors.lastname: Pattie
authors.affiliation: American College of Radiology, Reston, Virginia.
authors.forename: Pamela
authors.initials: P
authors.lastname: Kassing
authors.affiliation: Radiology Partners, El Secundo, California.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Heller
mesh_terms: D003952:Diagnostic Imaging / Q000191:economics*; D005102:Health Expenditures; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D018803:Models, Economic; D011871:Radiology / Q000191:economics*; D012017:Referral and Consultation / Q000191:economics*; D014481:United States; D000070376:Value-Based Health Insurance / Q000191:economics*
keywords: APM; Health care reform; Imaging 3.0; MACRA; MIPS; metrics; outcomes; payments; value