Socioeconomic J. Hillman,

Bruce Robert

#{149} Lee

B. Bernhardt,

BA

#{149} William

of a

tion

of that

panel discussion conducted as a Special Focus Session at the 77th Scientific Assembly and Annual Meeting of the Radiological Society of North America. The topic of discussion was “the new health care,” embodying the regulatory, reimbursement, and organizational structure of medicine, how these important influences are currently in flux, and how they might affect the practice of radiology.

you

live

During

presents

the past

the

details

decade,

and

most

certainly in the years to come, cians will be experiencing the

terms:

Economics,

and radiologists, Radiology

MD

#{149} Ronald

B. Schilling,

PhD

RSNA Special Focus Session on New Health Care”: Impact on Radiologists’

HIS article

Index

Y. Rial,

W. Vanderlish

1991 “The

T

MD

Issues

medical

socioeconomic

physirealiza-

.

Radiology

issues

1992; 184:309-314

panelist

ageless

of the Department

curse, “may The changes in health care have been dramatic. Assessing the complexity of these changes and how they may affect radiologic practice in the future is the challenge addressed by the panelists. Each in

Yiddish

interesting

times.”

represented

a different

point

of

view: technology manufacturer, radiologist, payer, and benefits management. Each discussed how the health care environment may affect radiologists from his own perspective. The panelists included the following: Ronald B. Schilling, PhD, senior vice president and general manager of Toshiba America Medical Systems, who has over 30 years of experience in high technology research and development, marketing, and management; Bruce J. Hiliman, MD, professor and chairman

of Radiology

at the

University of Virginia and senior scholar at the University of Virginia Center for Health Policy Research; William Y. Rial, MD, past president of the American Medical Association, a former member of the Joint Commission on Accreditation of Hospitals, and now di-

rector

of Provider

Relations,

the Blue

Cross and Blue Shield Association; and Lee B. Bernhardt, BA, director of operations for the United Mine Workers of America Health and Retirement Funds, who manages the health care benefits of retirees and their dependents for one of America’s most prominent unions.

Abbreviations: groups, HMO tion.

=

DRGs

=

health

maintenance

diagnosis-related

organiza-

‘ From the Department of Radiology, University of Virginia, Health Sciences Center, Box 170, Charlottesville, VA 22908 (B.J.H.); United Mine Workers of America Health and Retirement Funds, Washington, DC (L.B.B.); Blue Cross and Blue Shield Association, Chicago (W.Y.R.); and Toshiba America Medical Systems, Tustin, Calif (R.B.S., R.W.V.). From the 1991 RSNA scientific assembly. Received February 6, 1992; revision requested February 28; revision received March 18 and accepted March 18. Address reprint requests to B.J.H. © RSNA, 1992

Ronald

B. Schilling,

PhD

#{149} Robert

Manufacturers Manufacturers must predicate

future curred During

undergone practice,

of Radiologic

of radiologic their current

technology views and

plans on what has recently ocin the health care environment. the

past

25 years,

W. Vanderlish

medicine

a transition from to being a business,

has

being a to being an

industry. This has evoked efforts from payers, especially the federal government, to contain the rising costs associated with this transition. As the number of Medicare beneficiaries grew in the 1970s, hospital charges increased with the traditional, retrospective, cost-plus system. This prompted the implementation of a prospective payment system that was based on diagnosis-related

Technology

groups From change

(DRGs). the federal perspective, from a retrospective

system

to a prospective

system

the payment made

the growth of Medicare part A actuarially predictable. However, DRGs contributed to the emphasis on switching from inpatient to outpatient health care. As evidenced, this change bolstered the growth of Medicare part B services and

made

them

more

unpredictable.

Prospective payment drove hospital operating margins down dramatically. Hospitals transferred the shortfall to private paying patients (cost shifting). Health insurance costs increased sharply,

followed

by

insurance

compa-

nies raising rates and buyers, especially businesses, crying foul. Because business had a need to control health care costs, business raised employee premiums, increased deductibles, and offered

preferred health

(HMO)

provider maintenance

organization

and

organization

plans.

HMOs became a successful alternative to fee-for-service medicine, and large numbers of patients began to enroll. This enabled them to contract with hospitals from a position of strength-

hospitals

needed

patients.

Hospitals

were breaking new ground by contracting with HMOs on a discounted per diem basis. However, many hospitals

309

1991 RSNA special focus session on "the new health care": impact on radiologists.

Socioeconomic J. Hillman, Bruce Robert #{149} Lee B. Bernhardt, BA #{149} William of a tion of that panel discussion conducted as a Special F...
182KB Sizes 0 Downloads 0 Views