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Study Suggests Cardiologists Order More Images When Paid

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Study Results Not Unexpected

The findings by Dr. Shah and colleagues are not surprising.

The fee-for-service (FFS) model rewards volume-based services. But that doesn’t mean that these data describe physician self-interest as the central issue here. As noted by the authors, patient convenience and satisfaction in having personalized cardiovascular physician and diagnostic services connected in one location is of significant value. Ideally, that practice configuration should also be more efficient – and a positive aspect of the future health care system. These commentaries suggest not.

I believe a significant aspect of the observed differences between salaried and FFS practices relates to exposure to best practices and current science. That happens much more efficiently for cardiologists in academic and teaching centers and other salaried systems. Before we must consider throwing private practice out, as the authors seem to reluctantly suggest in their important and needed commentary, let’s try using the newly available clinical decision support approaches, such as American College of Cardiology’s PINNACLE outpatient registry, and the FOCUS system for appropriateness of imaging. If we had payment reforms that reward use of these kinds of tools, I am confident that the observed differences between salaried and FFS cardiology practices would disappear.

Jack Lewin, m.d., is the chief executive officer of the American College of Cardiology.


 

FROM JAMA

"Collectively, these limitations might explain much of the differences in use according to physician billing status," wrote Dr. Hollenbeck and Dr. Nallamothu.

They acknowledge that the findings are "robust," but they also say that "It is uncertain whether the observed increase in imaging utilization is entirely a bad thing."

A shift from the inpatient to the outpatient setting over the last decade or so has been linked to a dramatic decline in mortality from cardiac disease, they said. Office-based imaging might improve quality of care by leading to potentially earlier diagnosis, and keeping referrals close by may also increase the coordination of care, said Dr. Hollenbeck and Nallamothu.

But they also note that cardiology has been shifting back to the hospital, and that government regulators are creating policies that will likely encourage that move. That could lead to higher costs again, they said.

"Moving forward in the current era of health care reform, the focus should be less about eliminating incentives altogether, and more about getting the price right in the first place," wrote Dr. Hollenbeck and Dr. Nallamothu.

The study was funded by United Healthcare, and one study author was a United Healthcare employee. Dr. Nallamothu reported no conflicts. Dr. Shah and Dr. Hollenbeck both received grants from the Agency for Health Care Research and Quality.

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