January 28, 2022

UnitedHealthcare Rolls Out Designated Diagnostic Imaging Provider Program

UnitedHealthcare recently launched a new Designated Diagnostic Imaging Provider Program for select markets. The program evaluates imaging providers on quality and efficiency standards and offers patients tiered benefits based on their selected providers’ designation. The program goes into effect on July 1. A similar program was implemented for diagnostic laboratory services in 2021.

Providers are evaluated on a set of quality standards based on self-attestation in a short survey. The survey link was sent to providers in applicable UnitedHealthcare markets the week of Jan. 17. The quality measures include accreditation status, timeliness of care and test results, and submission of electronic images. Efficiency is measured by cost; all providers, regardless of practice setting, have the same cost target.

All providers who meet the minimum criteria for tier one will receive that designation. Providers who do not meet the criteria will be placed in the second tier. These providers will still be considered in-network providers, however the patient benefits will be reduced and, as such, patients will incur greater cost sharing for services. UnitedHealthcare stated in a discussion with the American College of Radiology® (ACR®) after the program was announced that quality and efficiency are considered equally when determining a provider’s tier level.

The ACR will continue to engage with UnitedHealthcare as questions and/or concerns about the program arise. The ACR encourages providers that receive the survey to complete it as soon as possible.

Additional information about the program may be found on UnitedHealthcare’s website.

For questions about the UnitedHealthcare Designated Diagnostic Imaging Provider Program, please contact Katie Keysor, ACR Senior Director of Economic Policy.