Vetting the quality of imaging services

 

Vetting the quality of imaging services

By Beth Kutscher  | January 2, 2016

Healthcare price transparency is slowly gaining ground as employers become more cost conscious, and consumers have to pay more out of pocket under high-deductible health plans. But a key missing link has been the ability of employers and consumers to obtain reliable information about quality as well as price.

Review sites have proliferated, but the ratings focus on factors such as customer service and wait times, rather than clinical quality and outcomes.

New York City-based Spreemo started in 2010, with a focus on helping employers and patients vet diagnostic imaging centers on quality and price. Radiology is a specialty where many consumers are able and willing to comparison shop. 

As an experiment, Ron Vianu, co-founder and CEO of Spreemo, sent his mother, who had lower back problems, to three magnetic resonance imaging centers in New York City. She underwent three scans and received three different recommendations and treatment plans. “Most people think radiology is a commodity,” Vianu said. But, he added, “there's very little consensus about what goes into quality.”

Spreemo has developed software that helps consumers evaluate quality and costs. It collects extensive data from providers, from their accreditation to their protocols, such as how many pictures they take per scan. The company grades imaging centers based on how accurately they interpret scans, the types of equipment they use, and their turnaround time. 

It has even launched its own Quality Research Institute that asks outside experts to develop consensus on what constitutes quality and to measure the impact on patient outcomes. The experts regularly review a random sample of scans from Spreemo's providers to complement the company's predictive modeling, with the idea that high-quality centers should have the least degree of variability. Spreemo's senior medical adviser, Dr. Richard Herzog, who directs spinal imaging at New York's Hospital for Special Surgery, heads the research institute.

Spreemo's current focus is on worksite injuries. Its main client base is large, self-insured employers and worker-compensation insurers. “Employers are very incentivized to get people better,” Vianu said. “If someone has less than optimal care, that's going to cost them.” 

Providers that want to join Spreemo's referral network send their data to the company. Employers and third-party administrators use the data to match patients to imaging centers. The data are sortable by quality metrics, price and travel distance to the listed centers.

Radiology services have become price transparent at a faster rate than other medical specialties, according to a study in the Journal of the American College of Radiology published in April. Researchers found that nearly 80% of academic medical centers and private radiology practices were able to provide prices for a head CT scan without a contrast agent. Rates ranged from $211 to more than $2,000.


 

SPREEMOCo-founder and CEO: Ron Vianu

Headquarters: New York

Innovation: A software platform that allows employers to find and refer employees to diagnostic imaging centers based on quality, turnaround time and price.

Status: Spreemo in June secured an investment from private-equity firm Pamplona Capital Management. It currently has more than 100 employees.

Radiology results can vary based on the type of equipment used, the software upgrades made and clinician skill, said Dr. Robert Epstein, chairman of University Radiology Group, which has 20 offices in central New Jersey. “Part of quality is good technology,” he said. “It's really about the machine, the software, the process and the radiologists.”

Epstein's group, which joined Spreemo's referral network three years ago, said Spreemo's focus on value encourages radiology groups to invest in high-quality equipment. “They stand out because they are more in tune with our focus on quality and value, and less so on absolute price,” Epstein said. The relationship also has helped connect the group with large employers. 

Epstein said many payers steer patients to the lowest-cost provider. But poor-quality imaging can end up costing more and producing a bad outcome. “If you save $100 or $200 on an MRI, but you have an unnecessary $50,000 back fusion, that's actually not so good for patients,” he said.

Spreemo recently surpassed 100 employees, and in June secured an investment from private-equity firm Pamplona Capital Management, whose size was not disclosed. Vianu said it has providers in every state. 

Looking ahead, the company sees an opportunity to provide payers and patients with the same type of assistance for other medical-specialty services. It also envisions marketing its software to organizations that are working under financial-risk contracts tied to patient outcomes.

Payers and consumers need to be able to understand what they're buying, Vianu said. “You want to go to someone who gets you better.”

Read the full article here.

 
Natasha Irani