How can breast centers navigate the shifting landscape of healthcare reform, reimbursement pressure, and evidence-based medicine? By reaching out to form patient care teams with other providers and tracking performance, according to a March 24 talk at the National Consortium of Breast Centers (NCBC) meeting in Las Vegas.
The old fee-for-service model rewards volume and ancillary utilization of imaging, said presenter Dr. Gary Levine, chairman of the program committee for the meeting and medical director of breast imaging at Hoag Breast Care Center in Newport Beach, CA.
Fee-for-service medicine encourages a competitive mindset among doctors, and it offers no incentive for improving the quality of care. And the government is taking notice, according to Levine, who cited a 2011 vow by the U.S. Department of Health and Human Services to shift Medicare "from payments based on volume to payments based on performance."
Private payors are also changing, and they can implement payment and utilization reforms without having to worry about retaining voters, Levine said.
"Healthcare reform is about using evidence-based medicine, and better coordinating care to improve the quality of that care, patients' access to it, and the cost of providing it," Levine said. "How is the overhaul being accomplished? Through regulation and payment reform -- starting now and ramping up over the next five to seven years."
There are a number of actions that breast imaging centers can take to thrive during this period of dramatic change, according to Levine. Start by making alliances and go from there, he said.
Develop integrated interdisciplinary teams. "Interdisciplinary teams using established clinical protocols will improve patient outcomes and provide cost-efficient care," Levine told session attendees. Who should be on these teams? Radiologists, surgeons, plastic surgeons, medical oncologists, radiation oncologists, psychosocial and genetic experts, and nurses, he said.
Measure quality. "This is the key to quality improvement, and data will drive reimbursement," Levine said. Invest in an electronic data collection and analysis tool and use it to measure patient outcomes and experience, as well as care coordination. Make use of Medicare's Hospital Compare and Physician Compare data.
Think "population health." The trend toward accountable care organizations (ACOs) is not going away, according to Levine. ACOs are provider-led groups accountable for quality and costs across the continuum of care for a particular patient population (hence the term "population health"); payments are linked to quality improvements that reduce overall costs, as well as reliable performance measures.
Working with others just might be the difference between surviving and thriving, Levine said.
"Integrated, multidisciplinary breast centers are positioned best not only to provide the highest quality care, but also to do it most cost-effectively," Levine told AuntMinnie.com.
