Neuroimaging clinics of North America
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The paradox of the increased use of imaging without obvious evidence of improved health outcomes has led to calls for payment based on value rather than volume. Measurement of radiologists' performance is a key component of the measurement of value. The paradigm shift occurring in radiology and health care as a whole may seem daunting to the radiologist with the clamor for increasing accountability from payers and patients alike. However, it is through powerful tools such as performance measures in radiology and their accompanying incentive-based payment systems that practices can be improved and confidence of patients restored.
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Neuroimaging Clin. N. Am. · Aug 2012
ReviewThe resource-based relative value scale and neuroradiology: ASNR's history at the RUC.
The Resource-Based Relative Value Scale (RBRVS) has been the defining algorithm for professional reimbursement of medical services since its introduction in 1992. This article reviews the history of the RBRVS, with an emphasis on the integral involvement of the radiology and neuroradiology communities. Appropriate reimbursement of radiology procedures has been chaperoned by physician volunteers and society staff attending Current Procedural Terminology Panel meetings and American Medical Association/Specialty Society RVS Update Committee (RUC) meetings. In recent years, governmental and RUC initiatives have created an unfavorable environment for neuroradiologists to maintain reimbursement levels seen previously.
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Turf issues in medicine affect policy, practice, and, most importantly, patients. This article explores turf issues from several perspectives. ⋯ Finally, this article focuses on proposed strategies to successfully confront the questions, if not overcome the problems encountered. To better inform the deliberation and strengthen the credibility of any conclusions, the evidence and controversies must be regarded from beyond merely the radiology perspective.
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Neuroimaging Clin. N. Am. · May 2012
ReviewHead and neck high-field imaging: oncology applications.
Head and neck imaging has benefited from 1.5 T magnetic resonance (MR) imaging, providing faster sequences, better soft tissue evaluation, and 3-axis imaging, with less radiation and iodine-based contrast injection. The US Food and Drug Administration has approved human MR imaging at high-field strength up to 4 T in clinical practice. 3 T MR imaging has become widely available, with the hope of significant advance in the evaluation of the head and neck region. This article reviews the benefits, disadvantages, and challenges of high-field imaging of the head and neck region, focusing on the imaging of head and neck cancer.
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Neuroimaging Clin. N. Am. · May 2012
ReviewVascular disorders: insights from arterial spin labeling.
The introduction of high-field magnetic imaging (≥3 T) has made noninvasive arterial spin labeling (ASL) a realistic clinical option for perfusion assessment in vascular disorders. Combined with the advances provided by territorial imaging of individual intracerebral arteries and the measurement of vascular reactivity, ASL is a powerful tool for evaluating vascular diseases of the brain. This article evaluates its use in chronic cerebrovascular disease, stroke, moyamoya disease, and arteriovenous malformation, but ASL may also find applications in related diseases such as vascular dementia.