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PPT : Economics: Future Practice Models
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*Market is driving change in the practice of radiology
* Possible new business models include
o Corporatization
o Consolidation of small programs into a large group
o Teleradiology/Nighthawk system
o Further Subspecialization
o Healthcare reform?
Effects of DRA and Rise of Radiology Benefit Management Groups
* Deficit Reduction Act 2005 (DRA)
o Went into effect in January 2007 and proposed millions of dollars in savings from mandatory spending programs primarily by slowing the growth of spending in programs such as Medicare and Medicaid.
o Imaging was a big ticket item growing at a double digit rate, and was therefore targeted for reimbursement cutbacks
+ Since that time, the growth of imaging has significantly decreased (recent calculations estimate the annual growth rate to have dropped to 3-4%)
o Lobbying efforts from Radac, MedPac, and other specialty PACs have limited the cutbacks affecting imaging studies
* Radiology Benefit Management Groups (RBM’s)
o Third party companies hired to control utilization of expensive imaging services through a pre-certification system
o Cost is essentially diverted from patient care in order to pay for further administrative costs
Board Examination Changes
* Core Examination:
o After 36 months of training
o Computer based, image rich
o Physics and written components
o Anatomy and case based
* Certification Examination:
o 15 months after completion of residency
o Computer based, image rich
o Will choose up to 4 sections (gi, gu, etc)
o Will have required general component (radiation safety, contrast reaction, etc)
* NO ORAL BOARDS
* Begins with class entering 2010
* How will this change call?
Potential Curriculum Changes
* With recent examination changes, the content of the 4th year of residency has been questioned
* The real debate is keeping the 4th year general or allowing a “mini-fellowship”
o What would small programs do?
o How would this affect the training of the 1st-3rd years?
o Would this affect the match system?
o Primary certificate for VIR?
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Tags: benefit management, business models, deficit reduction act, healthcare reform