利用率管理和ACR选择。

Radiology management Pub Date : 2015-03-01
Robert Cooke
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引用次数: 0

摘要

ACR,作为ACR Select出版,提供了成像的行业标准,并通过其在适当标准方面的经验,定位于快速响应不断变化的市场需求。它增加了数百种临床相关适应症,以确保即使是常见的情况也能得到覆盖。ACR选择包括许多其他可信的内容来源,并积极接受其他医学专业协会的审查标准。ACR Select在市场上建立良好,可集成到多个医生接入点。它还支持PL113-93的规定和要求。医疗保健提供商在其医生接入点中采用了ACR Select,以提供更高质量的成像服务,并了解成像对整个护理周期的影响。这将使这些供应商更好地参与到基于风险的合同中,这些合同基于适当的成像所带来的价值。随着PAMA的通过,国会开创了一个强有力的先例,为每个医疗保健付款人创造了改变成像利用管理方式的机会。医生在为医疗补助患者安排HTDI检查时,将被要求参考通过CDS提供的适当标准,这可以很容易地扩展到整个付款人组合。PAMA已成为公法(PLI113-93),为医疗保健提供者提供了一个机会,可以在所有成像服务中开发基于风险的支付模式,而不考虑索赔或护理设置的付款人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Utilization Management and ACR Select.

The ACR, published as ACR Select, provides an industry standard for imaging and through its experience with Appropriateness Criteria, is positioned to respond quickly to changing market demands. It has added hundreds of clinically relevant indications to ensure that even common scenarios have coverage. ACR Select is inclusive of numerous other credible content sources and actively receives vetted criteria from other medical specialty societies. ACR Select is well established in the market and available for integration into multiple physician access points. It also has support for the provisions and requirements of PL113-93. Healthcare providers have adopted ACR Select within their physician access points to deliver higher quality imaging services and understand the impact that imaging has on the overall care cycle. This better positions these providers to participate in risk-based contracts based on the value that appropriate imaging delivers. With the passage of PAMA, Congress has set a powerful precedent that has created the opportunity for every healthcare payer to transform the way imaging utilization is managed. Physicians will be required to consult Appropriateness Criteria delivered through CDS when placing orders for HTDI exams for Medicaid patients, and this can easily extend across the entire payer mix. PAMA has passed into public law (PLI113-93) and represents an opportunity for healthcare providers to develop risk based payment models across all imaging services, regardless of the payer of the claim or care setting.

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