Academic Radiology in the New Health Care Delivery Environment

Abstract

Ongoing concerns over the rising cost of health care are driving large-scale changes in the way that health care is practiced and reimbursed in the United States. To effectively implement and thrive within this new health care delivery environment, academic medical institutions will need to modify financial and business models and adapt institutional cultures. In this paper, we review the expected features of the new health care environment from the perspective of academic radiology departments. Our review will include background on Accountable Care Organizations, identify challenges associated with the new managed care model, and outline key strategies—including expanding the use of existing information technology infrastructure, promoting continued medical innovation, balancing academic research with clinical care, and exploring new roles for radiologists in efficient patient management—that will ensure continued success for academic radiology.

Lack of insurance is associated with lower probability of diagnostic imaging use among US trauma patients: An instrumental variable analysis and simulation

“…36 With certain caveats, the ACA represents an instrument, in that as of January 1, 2014, expansion of the Medicaid program and federal subsidies for private insurance under the ACA directly caused patients to obtain insurance, and patients shortly before and after this date would be similar in almost all ways except for having insurance. A potential violation of (ii) is that changes in Medicare and Medicaid reimbursement rules introduced by the ACA served to de-incentivize uncritical use of diagnostic imaging services, 37 as did the US Deficit Reduction Act of 2005, 38 which would bias in the opposite direction of our hypothesis.…”