Health Policy Agenda: Are Radiologists at the Table? (2021)-M4-CNPM06-2021

Video Transcription

Video Summary

The talk addresses health policy and radiology, focusing on patient steerage and its impact on pediatric care. Steerage is when insurance companies direct patients to specific facilities for treatment, often for cost-saving reasons. Anthem implemented a policy requiring advanced imaging to be done at outpatient centers rather than hospitals unless deemed medically necessary, affecting children over nine as adults. This sparked advocacy led by pediatric radiologists, emphasizing that children need specialized care. Through persistent advocacy with various organizations, including the SPR, AAP, AMA, and ACR, the policy faced criticism for not recognizing pediatric-specific needs. Although Anthem initially resisted, subsequent advocacy and mounting pressure helped reverse the policy. This also influenced other insurers like UnitedHealthcare and Cigna. The speaker concludes by highlighting the importance of speaking up for healthcare policies, stressing that persistence and collaboration can lead to successful advocacy. Additionally, they discuss the need for radiologists to be engaged in healthcare policies to ensure the appropriate implementation of imaging practices, emphasizing ongoing efforts like those seen in the National Lung Screening Trial.

Keywords

health policy

radiology

patient steerage

pediatric care

advocacy

insurance companies

specialized care

healthcare policies