This article explores the trend of “patient steerage”—a practice of payers directing patients to lower-cost imaging providers.

Some thoughts…

• The article also touches on the idea of patients with high-deductible insurance plans, and awareness of costs, steering themselves to lower cost options. How long until consumer-driven review web sites rating costs and quality (like a travel review and booking site) become ubiquitous? The site could even broker the scheduling across involved facilities, like a travel site does this for airlines.
• The frequent mention of quality of service as a method for imaging providers to differentiate themselves ties into the blog post I did on the SIIM web site here. The ability to offer services at a lower cost ties into my commentary on Productivity.
• This trend could have another implication on the management of results. Often, referring physicians will refer to an imaging provider that not only provides quality of service (summarized in the article as “scan quality, turnaround time, communication with referrers and patients”), but convenient results access. So, I might send my patients to Imaging Provider A because they provide me with a secure portal to access the report and images, and send me notifications when the results are available. If my patients are steered to an imaging provider with lesser capability (just faxes reports out), I would not be as productive (or happy). If patients are steered to several imaging providers in the area, how results are accessed may vary significantly from one exam to the next. Referring physicians in regions that have an operational HIE, capable of managing both reports and images, and providing a so called “EMR Light” portal function will likely experience less of a negative impact from patient steerage when accessing results.