MACRA has been implemented and it replaces the sustainable growth rate formula for radiology practices. MACRA is an incentive program to reward practices for quality and the value of care provided. It will no longer reimburse for quantity. So radiology practices have to move from the buffet to the dining room. The cost incentives can be up to 9% for Medicare patients when fully implemented in 2019.

Some radiology practices are trying to stave of the looming cuts while others look to profit from the system. The buffet style radiology which we all have grown up in has to stop. There has to be a system in place to stop referring doctors and Emergency doctors from ordering unnecessary test and procedures. ACR appropriateness criteria can help but it’s a tall task ahead.

The easier task is quality which is 60% of the MACRA criteria. Quality will be individual and group quality. The best way to accomplish quality reads is intelligent workflow management. The motto at PACS Harmony is the right case to the right doctor at the right time. Smart workflow distribution will increase subspecialty reads and will get the cases to the best person to read the images. It will increase efficiency, quality and profitability. The opposite is true if you take the business as usual approach…

There are many examples from our business and from my practice where the ‘wrong’ radiologist reads a case. We see often where there is an error or an oversight which would not have been made if the person just stuck to what they are good at. Most commonly it involves MRI interpretation but it can be any modality.

I always say that radiologists need to know their limitations. We are not all good at everything and some of us are bad at some things. (Not me, of course.) I know what my limitations are and I’m smart enough to ask for help when over my head. My specialty is Neuroradiology, and I used to say if I don’t know what it is in my field, then no one will. My attitude has changed a bit lately but I still have high confidence. However, give me a wrist MRI, I may cry uncle. I have gotten to the point where I don’t even read some exams anymore for I have experts in my group who can better read the cases then I… and they can do it faster. Greater accuracy and increased speed equals higher quality and profitability.

So the take away is to let the best person available read every case to increase the individual and the group quality. It’s not only better patient care but not earns you money!