The Year of the Snake: Radiologists Get Ready!

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Cristen Bolan, Executive Editor, Applied Radiology

Cristen Bolan, Executive Editor, Applied Radiology

Guest post by Cristen Bolan, executive editor, Applied Radiology.

For those of you who follow the Chinese calendar, you know that 2013 is the year of the snake, which according to ancient Chinese wisdom, a snake in the house is a good omen because the snake is cunning, therefore good at business and your family will not starve. That’s a relief.

With so many changes taking place in health care, like the “doc fix” in the American Taxpayer Relief Act of 2012, what good omens will Radiologists need to see in the coming year to be successful? If you hear the sound of “accountable care organizations” or “ACOs” reverberating in your ears, you’re catching on.

Yes, ACO has an ominous ring to it. Maybe because it’s an acronym, but everything in the medical field ends up as an acronym. This is to simplify the meaning, and ACOs are simply intended to be incentives for health care providers to work together to treat an individual patient across care settings — including doctor’s offices, hospitals and long-term care facilities.

Now, is that so scary? Well, the American College of Radiology (ACR) thought it wise for radiologists to brace themselves, and wrote a white paper on strategies for successful radiologist participation in ACOs, appropriately called Strategies for Radiologists in the Era of Health Care Reform and Accountable Care Organizations.1

In the paper, the ACR presented its best assessment of what’s in store for radiologists with regard to ACO development and how radiologists can prepare themselves and their practices for associated potential changes to the current payment system.1

Here are a few tips:

  1. Radiologists should seek leadership positions within local ACOs.
  2. Radiologists should strive to align themselves with any integrated health care provider organization that either becomes or joins an ACO.
  3. Radiologists must focus more on providing the best possible care to patients and still maintain cost-effective patient throughput.
  4. Radiologists should be paid on the basis of fee-for-service (FFS) or derivative payments, in which radiologists are incentivized for and responsible for utilization management.
  5. Furthermore, radiologists should take the lead role in utilization management. “Working closely with referring physicians, radiologists can best ensure that the imaging studies performed are those that are most appropriate, thereby reducing the need for follow-up studies.”1

The ACR warns that if radiologists are unwilling to assume leadership roles in the ACO, imaging could become a marginalized commodity within the ACO. The message is clear — when ACOs roll in, you better step it up!

But like other ominous predictions that fell short of disaster—the Y2K scare that had little to no effect on IT infrastructures, and the world did not come to an end on December 21, 2012—there’s a good chance radiology will ride out this storm too — and diagnostic imaging will not become a commodity.

But nothing has been decided yet — the Chinese New Year’s Day doesn’t fall until February 10, 2013.


1. Allen B Jr, Levin DC, Brant-Zawadzki M, et al. ACR White Paper: Strategies for Radiologists in the Era of Health Care Reform and Accountable Care Organizations: A Report From the ACR Future Trends Committee. J Am Coll Radiol. 2011;8:309-317.



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