Analytics Key to Catalyzing Change
By Bill Pickart, CEO, Integrated Medical Partners
 The central goal of the Patient Protection and Affordable Care Act (PPACA) is, as its name suggests, to restore patients to their rightful place as the center around which US health care revolves. Though the legislation is complex, the goal is simple: to incentivize an overburdened, decentralized system toward reducing costs while improving outcomes. Providers have a limited window in which to change the way that they manage their practices as the industry transitions to more sustainable care-delivery models.
This transition will be quite challenging. As radiology knows all too well (following years of reimbursement cuts), the imperative to do more with less necessitates sophisticated, intelligent use of real-time business and clinical data. In this issue of RadAnalytics, three members of a progressive practice"s leadership team hypothesize about what might be required from the specialty as alternative models of care and reimbursement take root. Though the definitive answers still remain to be seen, their predictions about what the future will hold are insightful.
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ACOs and the Radiology Practice: Adding and Quantifying Value
By Cat Vasko
 The stated aims of accountable-care organizations (ACOs) mirror the triple aim proposed by the Institute for Healthcare Improvement (Cambridge, Massachusetts), and both sets of goals have one common thrust: placing the patient at the center of the health-care continuum. As Linda Skarzynski, CFO for Triad Radiology Associates (Winston-Salem, North Carolina) notes, many radiology practices are well positioned to help. "Whether it"s now or in the future, patient safety is always the top priority," she says. "Any systems we can put in place to serve that goal better are what we want to pursue. In an ideal world, a radiology practice"s
priorities would be the same, irrespective of its participation in ACOs."
Skarzynski"s words emphasize what many in the radiology community have sought to underscore since CMS announced its ACO program: Radiologists can be stewards of smarter, safer, and more effective patient care. Rick Blake, chief business-development officer for independent physician group Cornerstone Health Care (High Point, North Carolina), concurs. "Radiologists have an important role to play," he says. "They have specialized training in both diagnosing and treating patients. That"s the skill set they bring to the equation, but they have to demonstrate that their skills translate into better care."
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New World, New Infrastructure: Informatics Requirements of Emerging Payment Models
By Cat Vasko
 Much has been said and written in anticipation of new payment models like the accountable-care organization (ACO), but one consideration that often falls by the wayside, in all the talk of risk and reward, is informatics, Tom Smith says. Smith is CIO of Triad Radiology Associates (Winston-Salem, North Carolina). "With ACOs still in the early stages of being created, there hasn"t really been a clear set of data requirements," he says. "Early on, I think there will be a lot of different requirements, depending on how the ACOs want to operate and how they will monitor outcomes."
Smith sees two major challenges facing radiology practices that will seek to interface with one or more ACOs, and both relate to the advanced aggregation and use of data that will be required to manage patients better and to demonstrate lower costs and better care. "The first challenge is the number of data points a hospital-based ACO is going to be trying to collect and monitor," he says. "The second is getting those data back to the ACOs in a usable manner. There are going to be some headaches in the next two to three years."
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New Payment Models: Where Culture and Business Intelligence Meet
By Cat Vasko
 The specifics of how the traditional radiology practice model will fit with the emerging paradigm of the accountable-care organization (ACO) remain unclear, but it is clear that radiologists should be thinking about how to bend the cost and quality curves, according to Ted Kerner, MD, CEO of Triad Radiology Associates (Winston-Salem, North Carolina). "Being a physician is like anything else—it"s easy to get complacent, and if you"re complacent, what kind of impact are you creating?" he says. "New models of health-care delivery are challenging, and no one knows what will happen, but being able to influence it is why you must get
involved."
Fundamental to any discussion of imaging in integrated delivery is utilization, Kerner says—and he notes that emerging payment models create an opportunity for radiology to regain some autonomy. "We used to be much more involved in controlling utilization, but under fee-for-service models, with hospitals and health systems vying for patients, they must be able to provide imaging anytime and anywhere," he notes. "Now, we have a chance to convince administrators that we can also assist with patient safety, ensure high-quality imaging, and ensure ease of access. Even in a non-ACO model, we should impress administrators with the value of these services, although this is even more difficult than in an integrated environment."
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Utilization Management Review
IMP's Analytics & Decision Support solution has the capability to generate data comparing physician utilization patterns to an ACO-specific standard.
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eHealth Initiative Issues ACO Recommendations
The eHealth Initiative has issued a report on its health IT recommendations in support of accountable-care organizations. Key takeaways include the importance of a flexible infrastructure, the need for greater focus on patients, and the imperative to support coordination across the care team.
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More Focus Needed on Chronic Illness: IOM
In a new report, the Institute of Medicine says that chronic illness is approaching crisis proportions in the United States, constituting 75% of the $2 trillion spent on health care annually. The IOM offers a framework for implementing cost-cutting strategies to reduce the impact of chronic illness.
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Atul Gawande on Culture Change in Medicine
Surgeon, public-health researcher, and New Yorker writer Atul Gawande, MD, shares research indicating that when caregivers act as what he calls pit crews (rather than as cowboys), their organizations deliver exceptional outcomes at lower costs.
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