When most people concerned with the delivery of healthcare -- whether as providers, administrators or payers --  think about Radiology Benefit Management, their first and often only thought is that RBM is useful, if at all, only to reduce utilization.  While this is an accurate assessment of most RBM programs it fails to recognize the great potential that a well-designed RBM program has to promote better medicine.  The primary focus of any RBM process is the identification of inappropriate use of high-cost imaging procedures.  What comes next separates the minimally utilitarian RBMs from those dedicated to fulfilling its true potential.

Care to Care, LLC. was founded long after other established RBM companies and has turned this to its advantage.  We had observed, from many viewpoints, the strengths and weaknesses of other RBMs and their approach to reducing wasteful imaging.  Perhaps the most glaring weakness we saw concerned the treatment of referring doctors.  All prior authorization programs require additional administrative work from the referrer, this is inevitable.  We determined that we would keep that burden to a minimum, would show respect for the knowledge and effort of the referring physician, and try to provide something of value in exchange for the extra effort we require. (I will discuss minimizing the administrative burden in future postings.)

Treating referring doctors with the respect they are entitled to receive becomes a vehicle that drives improved patient care.  No one questions that there is over-utilization of imaging procedures.  This should not however be read as an indictment of those who occasionally order a test that is not clinically appropriate.  

 

Continued