Evolent Health, Arlington, Virginia.
The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, Maryland.
J Am Coll Radiol. 2015 Jan;12(1):51-8. doi: 10.1016/j.jacr.2014.08.015. Epub 2014 Oct 25.
The US health care system is in the midst of disruptive changes intended to expand access, improve outcomes, and lower costs. As part of this movement, a growing number of stakeholders have advocated dramatically increasing consumer transparency into the quality and price of health care services. The authors review the general movement toward American health care value transparency within the public, private, and nonprofit sectors, with an emphasis on those initiatives most relevant to radiology. They conclude that radiology, along with other "ancillary services," has been a major focus of early efforts to enhance consumer price transparency. By contrast, radiology as a field remains in the "middle of the pack" with regard to quality transparency. There is thus the danger that radiology value transparency in its current form will stimulate primarily price-based competition, erode provider profit margins, and disincentivize quality. The authors conclude with suggested actions radiologists can take to ensure that a more optimal balance is struck between quality transparency and price transparency, one that will enable true value-based competition among radiologists rather than commoditization.
美国的医疗保健系统正在经历旨在扩大服务范围、改善结果和降低成本的颠覆性变革。作为这一运动的一部分,越来越多的利益相关者主张大幅提高消费者对医疗服务质量和价格的透明度。作者回顾了公共、私营和非营利部门中美国医疗保健价值透明度的总体发展趋势,重点介绍了与放射学最相关的举措。他们得出的结论是,放射学与其他“辅助服务”一起,一直是提高消费者价格透明度的早期努力的重点。相比之下,放射学作为一个领域在质量透明度方面仍处于“中游”。因此,存在放射学价值透明度目前形式主要刺激基于价格的竞争、侵蚀提供商利润率以及抑制质量的危险。作者最后提出了放射科医生可以采取的行动建议,以确保在质量透明度和价格透明度之间取得更理想的平衡,从而使放射科医生之间能够进行真正基于价值的竞争,而不是商品化。