Key Performance Indicators for value-based reimbursement in Radiology: a Review.

Abstract

Value-based reimbursement is increasingly discussed in association with efforts to develop modern healthcare systems value-based. Relevant information (clinical, economic) should support the reimbursement systems that mirror the actual cost and benefits of a healthcare service. The reimbursement model should be understandable by decision makers and commensurate with the hospital information system (HIS). HIS should be aligned with the clinical and administrative data collection required to support the characterization of the care episode and allow a calculation of the benefits and costs incurred. The significant amount of information that HIS can gather results in an information overload that healthcare managers and professionals hardly can simplify. KPIs are crucial measurement tools capable of compiling and aggregating such information's. Radiology departments are highly technology-related service, operator-dependent, involving multiple stakeholders and considered as an adjunct to quality care, but not a primary contributor to value. Current radiology reimbursement levels are based on the same over the past 20 years criteria. Given the complexity and the inadequate criteria the first stage for new reimbursement models development, the aim of this study, is the identification of appropriate metrics to be used to monitor and evaluate the quality of services provided. The identified 160 metrics were aggregated and synthetized according to the radiology value chain in seven categories in a total of 56 value KPI's.