SGR Countdown

We are in a three month countdown to another 25 percent financial cliff for physician reimbursement if Congress does not pass legislation reforming the flawed Sustainable Growth Rate (SGR) formula. In the latest SGR reform versions being proposed, a critical piece for Radiology is the inclusion of clinical decision support (CDS) for advanced diagnostic imaging.

CDS is a vital part of the American College of Radiology’s (ACR) strategy for the future of radiology. CDS leverages the years of research and time invested by the College in developing appropriateness criteria. Most importantly, CDS underscores our integrity as doctors: doing the right exam for the right patient at the right time. CDS also serves as a physician centric, data-based replacement for the proposed Medicare pre-authorization program promoted by the president’s budget over the past several years. CDS has also dramatically changed the conversation about radiology in Congress and the Centers for Medicare and Medicaid Services by delivering an important value proposition.

SGR reform still faces an uncertain future. But with Congressional Budget Office scoring SGR legislation as low as $150 billion, there has never been a better opportunity over the past decade to pass this legislation.

Although we are encouraged by the inclusion of CDS in the current congressional SGR reform packages, we must remain wary of how Congress intends to pay for this legislation.  As such, we must continue to remain vigilant that radiology does not suffer additional, or worse yet, disproportional cuts. Stay tuned to this blog and ACR communications for updates.

Author – Howard B. Fleishon, M.D., MMM, FACR

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