Smart shopper: Approaching price transparency in radiology

In terms of consumer transparency, radiology patients do not have access to information that would assist them in choosing a provider based on quality of care or price of services, argued a recent article published in the Journal of the American College of Radiology.

Instead, they are given pricing information from private and public entities that results in patients “price shopping” among radiologists when looking for care.

Authors Daniel J. Durand, MD, of Johns Hopkins University School of Medicine in Baltimore, and colleagues wrote this creates the danger that radiology value transparency in its current form will stimulate primarily price-based competition, erode provider profit margins, and de-emphasize quality.

The authors noted that within the same metropolitan area, the market for medical imaging can have up to 500 percent price variations.

While certain disciplines in the medical field are at the forefront of price transparency, radiology finds itself in the middle of the pack, but change is in the air, Durand and colleagues noted. Several state and federal initiatives are on the horizon pushing the demand for value transparency, including two provisions in the Patient Protection and Affordable Care Act that will mandate public disclosure of hospital pricing data and disclosing premium pricing data and estimated out-of-pocket costs for procedures.

Industry experts, according to Durand and colleagues, believe that part of the answer to improving value in health care is to increase transparency on price and quality. In addition, increasing patient cost consciousness using means such as higher deductibles, could begin to correct such wide pricing variations in the radiology field.

Instead of resisting the trend of quality transparency, the authors argue, radiologists should welcome it. Radiologists can avoid commoditization by defining quality in their field and engaging in value-based competition.

Durand and colleagues provided four suggestions for fellow radiologists. They were:

• Investing in research and establishing specific metrics that facilitate quality comparisons among providers;
• Supporting professional societies that provide oversight of quality metrics;
• Participating in quality metric registries. Large databases encourage more accuracy- and performance-based metrics that are more reflective of radiologists’ skills; and
• Radiology professional societies should invest in research to demonstrate the high consequential costs and poor results associated with low-quality imaging.