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the referring physicians, and implement quality initiatives hospital-wide," says Dr. Zaidi. "We supplied a lot of leader- ship in strategic planning and ideas for quality improvement. We also hired clinical coordinators to expedite care and a marketing director to work with the hospital's marketing department." Pay-for-performance After agreeing to a shared-governance approach, the next step was to develop a pay-for-performance program. The goal was to build a platform for improving quality, with transparency and a focus on clinical outcomes. The performance metrics were jointly agreed upon by the hospital and the radiologists. Once the metrics were in place, a fair market value was assigned to them. "A few process metrics, such as turn- around times, were included," Dr. Zaidi explains. "But greater emphasis was placed on metrics linked to clinical outcomes, such as CT biopsy accuracy, mammography recall rate and inferior vena cava (IVC) filter retrievals." In addition, metrics were established a round overa ll depa r tment perfor- mance — for example, the length of time between the receipt of an order a nd t he performa nce of t he imag- ing study. "The point of co-management is that the physicians are leading the whole service line and everyone involved with it, so we are responsible for ensuring the improvement of the entire process of how a patient obtains radiology treat- ment at the hospital," says Dr. Zaidi. A Patient-centric Model Improved patient-centered care is at the heart of any co-management agree- ment, according to Dr. Zaidi. And that's why his group employs two care coordi- nators. Utilizing data mining software, they actively follow up on inpatients and outpatients to expedite their care, reduce their length of stay and reduce their costs. The resulting improvement in outcomes is impressive. "Comparing outcomes in 2013 with those of 2014, we reduced the time from initial imaging to biopsy by three whole days for inpatients, which decreased their length of stay and costs," says Dr. Zaidi. "Our care coordinators, who follow up directly with patients as well as physicians, were also able to increase IVC filter retrieval rates by 26 percent from 2013 to 2014. That's an important issue, because the latest FDA guidelines indicate that IVC filters should not be left in for life if it's not necessary." Radiologists also proactively identify patients with positive findings and contact the ordering physician directly for immediate intervention. As a result, procedures such as drain placements and aspirations are now performed the same or next day, thereby eliminating multiple physician referrals and duplicated imag- ing or lab studies. Through report reviews, process evaluation, and standardization, RAC radiologists have shifted from being consultative physicians to active partners in patient-centered care. Practice revi- sion and standardizations have improved the care-delivery model which, in turn, has improved the working relationship between the radiology group and hospital administration. For all involved — the patient, the physician and the hospital — this is a win-win-win. National Recognition All in all, RAC's co-management model with Aultman has been so successful that the radiology group was recognized by the American College of Radiology (ACR) as a leader in implementing Imaging 3.0, the goal of which is "to deliver all the imaging care that is beneficial and necessary and none that is not." A case study detailing R AC's approach and implications for patient care is posted on the ACR 3.0 website. In reality, RAC's co-management agreement with Aultman was established, and RadHelp was subsequently launched, even before Imaging 3.0 was introduced. Now Dr. Zaidi and his colleagues hope to adapt their value-based, high-quality care to other service lines within the hospitals they serve and with other hospitals and radiology groups across the nation, as well. "Healthcare reform is leading to a value-based payment methodology which requires a sea change in the way hospitals and physicians practice medicine," says Dr. Zaidi. "RadHelp can simplify the change process." For more information about RadHelp, visit RadHelpLLC.com or call 800-794-5518. For more information about Radiolog y Associates of Canton, visit RadCanton.com or call 330-363-2842. ■ COV ER FE AT UR E GRAPH COURTESY OF RADHELP LLC, CANTON, OHIO 8 | Cleveland/Akron/Canton MD NEWS ■ M D N E W S . CO M ■ M AY/J U N E 2 0 1 5