It’s simply a matter of time before all aspects of the Affordable Care Act’s (ACA) provisions are implemented, and we should expect the spread of payment models emphasizing bundled care, shared risk and quality driven reimbursement for Diagnostic Radiology groups.
Rarely has there been a defining time for radiologists than right now, when the survival of Diagnostic Radiology practices is squarely placed on the shoulders of the most efficient Diagnostic Radiology revenue cycle management procedures. It’s survival of the fittest.
“The Affordable Care Act has a ‘growing profound effect’ on radiology, according to Cindy Moran, assistant executive director for the American College of Radiology. “The ACA is accelerating the transition away from a fee-for-service reimbursement model. Payment systems will become more hospital-centric with bundled payments,” she said.
In June 2012, the MGMA-ACMPE released the results of a questionnaire that ranked members’ most pressing practice management challenges. No. 2 was: Preparing for reimbursement models that place a greater share of financial risk on the practice.
Within the next five years, diagnostic radiologists will be adopting this shared-risk model for revenue reimbursement (vs. fee for service) with the emergence of population health management through Accountable Care Organizations (ACO) that coordinate care and meet performance standards of care for Medicare patients.
The federal government, in tandem with commercial insurance companies, is changing the way patients pay doctors and hospitals in the new ACO environment. The reimbursement environment is transitioning from volume-based (fee for service) to a value-based (pay for performance) one focusing on quality care and efficiency.
As a result of ACOs and its correlating population health management and shared risk models, Diagnostic Radiology revenue cycle management models need to change too. This means proper Diagnostic Radiology medical coding and billing procedures are vital to a practice’s strong heartbeat. It’s an exacting science that requires in-depth, insider industry expertise of the myriad of new Diagnostic Radiology coding, billing and compliance regulations that only an independent third party Diagnostic Radiology revenue cycle management specialist with decades of expertise can provide to ensure nothing falls through the cracks and revenues are optimized.
revMD.com is the results-proven alternative for healthcare revenue cycle management, with a niche specialization in medical coding and billing that generates unprecedented results and builds profitable medical practices. Leveraging a history of industry wide success spanning 25 years, revMD.com partners with medical practices in Arizona and throughout the U.S. to optimize revenue for hospital based and practice based physicians.