Seeing the Whole Picture

 

Dr. Emrick's Books and Articles

How Value-Based Care and Patient Experience Are Reframing Radiology’s Place in Population Health

While conducting research, I paused to reflect on the changing radiology landscape. Just a decade ago, patients would have travelled a very different path, one governed by limited options. Today and in the future, access will be built around personal convenience. Those old radiology processes are fading fast. In its place, value-based care asks radiology departments to look beyond individual slices of an image and toward the well-being of the communities that depend on them. So, why is value-based care at the doorstep of radiology? Simply put, value-based care ties payment to the balance between outcomes and costs. For imaging, this metric involves more than just test accuracy; it encompasses downstream effects such as reduced readmissions, improved chronic disease control, and earlier detection through appropriate screening. Multi-society statements have advocated this broader perspective for well over a decade, predating the pandemic. Still, the urgency has increased as payers implement bundled payments and episode-of-care models that reward collaborative management over isolated transactions. Radiology, once regarded as a cost center, now has the opportunity to become a strategic driver of outcome improvement through evidence-based protocols, decision-support tools, and alignment with primary-care quality goals.

Needless to say, payment reform alone does not guarantee that imaging services feel person-centered. Experience surveys, especially the Outpatient and Ambulatory Surgery CAHPS instrument, which became mandatory in 2024, provide patients with a structured channel to comment on their communication experiences, preparation for procedures, and post-discharge guidance. Early results indicate that radiology’s historical focus on technical excellence needs to expand to encompass the warmth of front-desk greetings, clarity of consent discussions, and timeliness of report delivery. Patient-friendly reporting—plain-language summaries that accompany official interpretations—reduces anxiety and improves comprehension. Recent JACR data reveal measurable gains in satisfaction when these reports are routinely offered. Transitioning from episodic imaging to population stewardship requires radiologists to consider social determinants, screening gaps, and access barriers. A 2024 viewpoint in JACR outlined practical steps, including partnering with community clinics to schedule mobile units in underserved neighborhoods, designing imaging algorithms that account for transportation constraints, and engaging in legislative advocacy to preserve coverage for high-yield screening programs. When radiologists help craft such strategies, they transition from passive diagnosticians to active participants in the prevention of chronic diseases. Notably, federal regulations reinforce these expectations. For the 2025 performance year, CMS lifted scoring caps on radiology-specific measures within MIPS, allowing practices to receive full quality credit for demonstrating improvement in outcomes.  At the same time, the agency is discussing a mandatory episode model that would bundle imaging services with procedural and post-acute care, prompting the American College of Radiology to challenge aspects of compulsory participation, yet acknowledging that future reimbursement will hinge on noticeable value. Leaders who monitor these shifts are better prepared to renegotiate payer contracts and invest in care-coordination technology before penalties arrive.

In another significant shift, artificial intelligence promises to shorten report turnaround times, flag incidental findings that warrant preventive follow-up, and predict the risk of no-shows, allowing schedulers to intervene. Commercial platforms unveiled at the 2025 European Congress of Radiology feature population-screening dashboards that stratify risk across thousands of mammograms or CT colonography studies in near real-time. Yet a March 2025 Pew analysis cautions that oversight gaps remain, particularly around algorithm drift and bias against historically marginalized groups. Value-based contracts that hinge on equitable outcomes will fail if new tools silently widen disparities, underscoring the need for continuous monitoring and transparent validation. Radiology departments that wish to thrive under value-based expectations can start with straightforward actions. First, map the patient journey end-to-end and identify moments where uncertainty or delay occurs, such as parking, registration, gowning, and result delivery, and assign ownership for redesign. Second, embedding evidence-based appropriateness criteria within ordering workflows, reducing unnecessary scans while protecting revenue through stronger payer trust. Third, publish consumer-facing performance dashboards that track wait times, dose indices, and same-day add-on capacity; transparency builds credibility with both patients and primary-care partners. Finally, invest in staff training that highlights empathetic communication, because a courteous technologist can salvage the experience of a patient who arrives anxious about potential cancer.

So, how do we move forward systematically? Value-based care asks every specialty to justify its role in the health of populations. Radiology answers that challenge uniquely: by seeing disease before symptoms arise, by guiding interventions with minimal invasiveness, and by providing data that power predictive analytics for entire risk pools. The discipline’s future will belong to practices that marry technical excellence with human-centered design, harnessing AI while guarding against bias, and viewing each image as an intersection between personal narrative and community well-being. Readers building imaging programs, whether in an academic center or an outpatient joint venture, can lead this shift today by measuring what patients feel, not just what scanners detect, and by proving that radiology delivers measurable value where it matters most: healthier lives and happier patients.