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From Volume to Outcomes: The Evolution of Pay for Performance in Medical Imaging

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Radiological Safety and Quality

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Abstract

Although long ago established as the basis for physician remuneration in the United States, fee for service reimbursement systems are increasingly challenged by payers and consumers alike. As various stakeholders seek avenues to promote quality, enhance safety and improve outcomes, value based health care purchasing models receive ever-increasing attention. Trends, challenges and possible innovations in pay for performance programs, particularly as they relate to the physician component of medical imaging, are discussed.

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Abbreviations

ABR:

American Board of Radiology

ACO:

Accountable Care Organization

ACR:

American College of Radiology

CMS:

Centers for Medicare & Medicaid Services

CPT:

Current Procedural Terminology

FFS:

Fee for Service

GDP:

Gross Domestic Product

IAC:

Intersocietal Accreditation Commission

MIPPA:

Medicare Improvements for Patients and Providers Act

MOC:

Maintenance of Certification

MPPR:

Multiple Procedure Payment Reduction

MQSA:

Mammography Quality Standards Act

P4P:

Pay for Performance

PPACA:

Patient Protection and Accountable Care Act

PQRI:

Physician Quality Reporting Initiative

PQRS:

Physician Quality Reporting System

RBRVS:

Resource Based Relative Value System

RUC:

RVS Update Committee

RVU:

Relative Value Unit

SGR:

Sustainable Growth Rate

TJC:

The Joint Commission

UCR:

Usual Customary, and Reasonable

US:

United States

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Author information

Authors and Affiliations

  1. Harvey L. Neiman Health Policy Institute, 1891 Preston White Drive, Reston, VA, 20191, USA

    Richard Duszak Jr.

  2. South Texas Radiology Group, University of Texas Health Science Center, San Antonio, TX, USA

    Ezequiel Silva III

Authors
  1. Richard Duszak Jr.
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  2. Ezequiel Silva III
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Corresponding author

Correspondence to Richard Duszak Jr. .

Editor information

Editors and Affiliations

  1. International Radiology Quality Network, Reston, Virginia, USA

    Lawrence Lau

  2. Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, Malaysia

    Kwan-Hoong Ng

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Duszak, R., Silva, E. (2014). From Volume to Outcomes: The Evolution of Pay for Performance in Medical Imaging. In: Lau, L., Ng, KH. (eds) Radiological Safety and Quality. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7256-4_25

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  • DOI: https://doi.org/10.1007/978-94-007-7256-4_25

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  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-7255-7

  • Online ISBN: 978-94-007-7256-4

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