“The rationale for all of this is that an early, accurate diagnosis is the gateway to a rational care plan, both in the form of quality of care and counseling about management of chronic conditions and safety,” said Donohoe.

The study will involve around 300 sites and enroll about 9,000 patients per year for about two to three years. But after the 18,000 patients are recruited, CMS will close the study. From there, Donohue estimates a few more years may pass before value is determined and reimbursement becomes a reality.


“The good news is that for two to three years we are going to be able to do amyloid imaging on our patients, but then once the study is closed it’s going to be another couple of years before we are able to go through that data and we’re not going to have the imaging available to us,” he said.

Strategies for coping with new payment systems

The health care industry is moving away from fee-for-service and toward value-based payment systems, including Accountable Care Organizations. ACR developed the Imaging 3.0 program to assist radiologists in making that transition.

"We understand that this is where the system is going — we just need to find our leadership role in it,” said Dr. Geraldine McGinty of NewYork-Presbyterian Weill Cornell Medical Center. “We have to work harder and smarter than everyone else and I think we’re very well-equipped to do it.”

McGinty said that a lot of the solutions may seem counterintuitive for radiologists. “We are going to have to look for solutions that might feel wrong and might feel uncomfortable and I feel that is where we have to be,” she added. “All of you will know that change is really hard and this is where Imaging 3.0 comes in.”

Part of Imaging 3.0 calls for a change in culture, said McGinty. Radiologists must change the culture of how they are perceived so that people don’t think they are invisible.

Much of that can be achieved by having better communication with patients. At Boston Children’s Hospital, the residents are receiving training on how to communicate with patients after an ultrasound exam. Actors are playing the roles of patients so the residents can learn how to communicate good news and bad news.

In addition, NewYork-Presbyterian is rethinking the way they structure patient inquiries. Primary care physicians are being inundated with questions about breast density, but now radiologists are helping them supply the answers.

“It’s changing the culture so that our primary care doctors are not at all uncomfortable with us talking to their patients because we are meeting a need for them,” said McGinty.

Primary Care Homepage