A Radiologist's Primer on Bundles and Care Episodes.

Area of Science:

• Health economics
• Radiology
• Healthcare management

Background:

• Bundled or episode payments are key healthcare redesign strategies.
• These payment models incentivize care coordination, efficiency, and accountability.
• Radiology's role in these models is often underestimated but is poised for significant growth.

Purpose of the Study:

• To explore the increasing involvement of radiology in bundled payment models.
• To identify potential future bundled payment structures impacting radiology.
• To highlight radiology's pivotal role in high-impact clinical areas.

Main Methods:

• Analysis of current bundled payment trends and their implications for radiology.
• Identification of three potential models for radiology's integration into bundled payments.
• Review of radiology's involvement in key diagnostic and management areas.

Main Results:

• Radiology is central to managing conditions like low back pain, stroke, breast cancer, and pulmonary nodules.
• Three bundled care models are likely to involve radiology: pure radiology bundles, clinical bundles, and imaging pricing based on follow-up for incidental findings.
• These models will require pricing based on guideline-based frequencies and evidence-based follow-up imaging.

Conclusions:

• Bundled payments will increasingly integrate radiology into care redesign.
• Radiology's pivotal role in diagnosis and management necessitates its inclusion in payment models.
• Future bundled payment structures will likely focus on specific clinical pathways and diagnostic imaging utilization.