Utilization management in radiology, part 2: perspectives and future directions

Area of Science:

• Radiology and Health Economics
• Medical Imaging Utilization Management

Background:

• Increased medical imaging utilization in the early 2010s spurred efforts to control healthcare spending.
• Current initiatives focus on managing utilization through radiology benefits managers and real-time order entry decision support systems.

Purpose of the Study:

• To review anticipated trends in radiology utilization management.
• To discuss the potential future roles of radiologists in utilization management, considering emerging physician payment models.

Main Methods:

• Review of current initiatives in radiology utilization management.
• Historical analysis of pharmacy sector programs for parallels.
• Discussion of emerging physician payment models.

Main Results:

• Pharmacy sector programs offer potential parallels for medical imaging utilization management.
• Radiology benefits managers and real-time decision support systems are key current initiatives.
• Emerging physician payment models will influence the role of radiologists.

Conclusions:

• The pharmacy sector's experience provides a roadmap for medical imaging utilization management.
• Radiologists' roles are evolving within utilization management frameworks.
• Future strategies must integrate cost-control measures with clinical practice and payment reform.