Unsustainable spending, rapidly rising insurance premiums, an increasingly fragmented delivery system, and burgeoning consumerism are all culminating in policy initiatives that will transform the way healthcare is provided—and paid for—across the country.

Value-based cost sharing, which encourages patients to use treatments, services and providers that deliver value, offers a pathway to high-value care, according to a review in the April issue of Health Affairs. The authors delved into the rationale for and types of value-based cost sharing before listing a few cautions.

It’s a big week in radiology. For starters, it appears that there might be the tiniest bit of traction, at last, in closing the pernicious Stark loopholes. Multiple research studies and a policy statement suggested healthcare may be making strides toward personalized cancer screening. And finally, a photolog and video demonstrated the potential power of patient engagement.

The Obama administration’s budget proposal for Fiscal Year 2014, announced April 10, recommended closing the in-office ancillary services exception (IOASE) to the Stark law, which the Office of Management and Budget (OMB) said would save the government over $6 billion over 10 years.

Kevin McNamara, Nova Scotia’s deputy health minister, has accused 27 radiologists of “potentially inappropriate billing” over a two-year period. The dispute centers on use of a CT fee code for certain procedures in four provinces.

Quebec physicians are lobbying the provincial health board to reverse its decades-long policy of “two-tiered medicine” that limits imaging reimbursement to exams provided in public institutions. The wait for CT, MRI and ultrasound exams in hospitals can extend to two years, while the costs for MR studies in private institutions can reach $1,000.

A first look at President Obama’s proposed budget indicates that the POTUS has set his sights on the oft-reviled Stark loopholes.

Examining breaches in professionalism can help radiologists learn what it means to act in a professional manner, according to an article published in the April issue of the American Journal of Roentgenology.