Healthcare reform and new emerging legislation are making a difference for patients, but placing bigger demands on radiology.

Matthews.Marianne_1467_colorBy Marianne Matthews

It’s September. For many American families, that means back to school. September is also the time of year when many people schedule their annual physicals. And with that, I imagine several are asking themselves: Am I better off—or worse off—since the passage of the Affordable Care Act (ACA)?

My own anecdotal research—conducted admittedly in just a single state, New York—delivers startlingly disparate findings. Several of my acquaintances call the ACA a “disaster” and a “nightmare.” For example, a professional middle-aged woman and her 20-something-year-old son had high hopes for the legislation, but say they are both paying higher premiums and an exorbitant deductible. Conversely, a single, middle-aged musician friend of mine says the ACA is the best thing that ever happened to healthcare in the United States.  She’s paying a lower premium than she ever has—under $150 a month—and “getting better coverage than ever, including all kinds of specialists.”

One thing we can all agree on is that President Obama’s ACA is a very complicated and very controversial piece of legislation. There continues to be heated debate as to whether we are better off with it…or were better off before it.

But if we measure the effectiveness of the ACA for our society as a whole, the facts point to better off. Under the ACA, preventive and wellness healthcare services are more affordable and accessible for the majority of the population. For women, the ACA means free mammograms, screenings for cervical cancer, and gestational diabetes screening. For American children, the ACA means free immunizations for measles, hepatitis, and other diseases. For former smokers at high risk for lung cancer, the ACA requires private insurers to cover low-dose CT screening. And private insurers are required to cover screenings for cholesterol, depression, various cancers, HIV, and more, for most adults.

The bottom line, according to the US Department of Health and Human Services: In 2011 and 2012, 71 million Americans with private health insurance gained access to preventive services with no cost sharing—that means, no co-payment, co-insurance, or deductible—because of the healthcare reform law.

Say what you will, but I say, the US healthcare system was broken, and the ACA is the beginning of what will likely be a long-term repair job. Some progress is better than no progress.

Just as healthcare consumers are evaluating whether they are “better off, ” so, too, are radiologists. Many of the government mandates—in regard to meaningful use and image sharing, electronic health records, patient portals, and more—are making the business of radiology more arduous than ever before. Simply put, healthcare reform has pushed radiology to deal with a multitude of changes financially, legally, and technologically.

And there will likely be more changes to come. That’s why we’ve dedicated our Sept/Oct issue to health policy. In those pages—and here online—you’ll find articles about breast density legislation; radiation dose monitoring mandates; and the politics and policy surrounding low-dose CT screening for lung cancer for high-risk Medicare patients.

That’s right, “R&R” hardly stands for “rest and relaxation.” Rather, it’s about “regulatory and reimbursement” issues that are pushing you to change and grow. Look for content here online  and in the next print issue.

The ACA has forced radiologists to get out of the basement, and engage with the patient and play a greater consultative role on the care team. Healthcare reform is moving radiology out of a dark room and into the light. In the long run, radiology may be better off.