Borgstede's Letter on UHC Pilot Project


November 11, 2004

Dear Member:

I am writing to inform you of a pilot project being launched by UnitedHealthcare (UHC) called "Excellence in Radiology." Their intent is to encourage patients and providers to utilize the radiology services of sites that meet the "Excellence in Radiology" criteria. Initially, they will be conducting a survey of 151 UHC network outpatient radiology centers in Houston, North Carolina, and Colorado. The results of the survey will allow them to "highlight top performers and to recognize and designate facilities for their commitment to quality, safety and the appropriate use of resources in imaging." However, it is important to be aware that sites that do not meet the criteria will not be excluded from existing UHC networks.

UHC consulted the ACR on this project to gain our insight and expertise on what constitutes quality patient care in radiology. With our input, they are basing this new designation on such elements as having accreditation, board-certified radiologists, and appropriately credentialed technologists. While the pilot test of the survey will go only to radiologists, it is the intent of UHC to expand the survey to all providers of imaging services.

As you are well aware, federal and private payers across the country are looking at providers to document the quality and appropriateness of their work. In some areas, this is being done by utilization management companies with little or no input from radiologists. We are pleased that UHC sought the input of the ACR and are looking for ways to incorporate our quality initiatives into their programs. As they expand their survey to other imaging providers, we believe it will also help to reduce inappropriate imaging by those who are not committed to quality imaging.

While this pilot is being finalized, the College is continuing to work closely with UHC to ensure that all appropriate avenues related to participation in the pilot are explored, including consideration of appeals and reinstatement.

This UHC pilot could have the potential for enhancing the practices of ACR members. We will watch its progress closely.

Sincerely,

James P. Borgstede, MD, FACR
Chair, Board of Chancellors