The Future is Now: ACR Takes The Lead on MIPS Radiology Payment

The following post was contributed by Geraldine McGinty, MD, MBA, FACR.

If you read my June 2015 ACR Bulletin article, you know big changes are on the way for radiology (and other physician) payment. The American College of Radiology (ACR) is working, as part of the new Health Care Payment Learning and Action Network (HCPLAN) initiative, to produce quality metrics to ensure radiology is positioned for success in new health care delivery and payment models.

By 2022, under the newly established Merit-based Incentive Payment System (MIPS), Medicare radiology payments may rise or fall as much as nine percent. Additional bonuses will be available for exceptional performance.

In the near future, ACR will task thought leaders with ensuring that we have a robust model to communicate to the Centers for Medicare & Medicaid Services (CMS) and other payers. We want input from leaders in quality, metrics and informatics; representatives from various practice types; and other radiology stakeholders as well as those from allied professions.

You will hear much more on these issues in the coming months. Please don’t hesitate to be in touch with your thoughts and questions on this important effort. As always, you can reach me at gmcginty@acr.org , and I encourage you to follow me on Twitter at @DrGMcGinty.

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Powerful Forces Join Together to Condemn Draft USPSTF Breast Cancer Screening Recommendations

The following post 168_Breast_Cancer_Screeningwas contributed by ACR member Murray Rebner, MD (second from left in photo) , immediate past president of the Society of Breast Imaging (SBI) and professor of diagnostic radiology and molecular imaging at Oakland University William Beaumont School of Medicine.

This week I took part in a Capitol Hill briefing hosted by the Congressional Families Cancer Prevention Program of the Prevent Cancer Foundation and the Society of Breast Imaging (SBI). The topic of the briefing titled, “Breast Cancer Screening: Ending the Confusion,” was the U.S. Preventive Services Task Force (USPSTF) breast cancer screening guidelines. Representative Debbie Wasserman Schultz (D-FL) who credits mammography for ultimately saving her life joined the panelists in condemning the USPSTF guidelines.

The USPSTF guidelines, if implemented, would restrict access to mammography screening for women aged 40-49, many of whom would no longer be able to afford screening because their private insurance plans may no longer cover the procedure. The Affordable Care Act mandates that insurance plans cover exams and procedures rated “B” or higher by the USPSTF. The new guidelines grade routine mammography for women aged 40-49 a “C.” In addition, women 50-74 who want to be screened annually might be denied yearly coverage since the USPSTF guidelines only gave a “B” rating for screening this age group every other year.

Wasserman Schultz was clear that she and other members of Congress are concerned about the impact of breast cancer and believe that delayed detection and treatment have a far worse outcome than the harms of the USPSTF guidelines.

During the briefing I questioned the task force’s expertise as well as the transparency of their methodology. I also took issue with their priority to spare women the harms of mammography, despite their own admission that screening over the age of 40 reduces breast cancer deaths by 18 percent.
Dr. Elizabeth Morris, president of the Society of Breast Imaging (SBI) and Chief of Breast Imaging Service at Memorial Sloan Kettering Cancer Center, called for a moratorium on the guidelines, noting that the data used was old, discounted and did not account for technological advances, such as 3D mammography, which improves detection rates and decreases harms.

Dr. Regina Hampton, Medical Director and Co-Founder of Breast Care for Washington, provided a practitioner’s view. She talked about diagnosing a 38 year old, a 32 year old and a 39 year old with breast cancer in just the last couple of weeks.

So what is being done to prevent the USPSTF guidelines from being implemented? Representative Wasserman Schultz along with over 60 of her colleagues sent a letter to HHS Secretary Burwell asking her to take action. Wasserman Schultz said she will continue to fight to ensure women’s access to mammography screening is maintained. Professional societies like ACR and SBI, patient organizations like Prevent Cancer and providers like Dr. Hampton are educating policymakers, the media and the public about the potential harms and asking them to take appropriate action so that mammograms can continue to save lives.

ACR and AMA Membership: Strength in Numbers

AMA
The following post
was contributed by Raymond Tu, MD, MS, FACR, Arl Van Moore, MD, FACR, and David Rosman, MD, radiology members of the AMA House of Delegates (pictured left).

Radiology represented itself well at The American Medical Association (AMA) House of Delegates (HOD) meeting, with attendees from the American College of Radiology (ACR), radiology specialty societies and radiologists who serve as State Delegates. We joined more than 500 voting delegates from state medical societies and more than 130 specialty medical associations to voice our opinions in Chicago, June 6-10, 2015.

There were two important issues to radiology that your AMA delegation addressed on your behalf. We were successful in objecting to language that could be detrimental to radiology practices in the areas of the Ethical Practice of Telemedicine and also to proposed changes to the Centers for Medicare & Medicaid Services (CMS) physician supervision rules. Both issues were referred back to the AMA Board of Trustees for additional clarification to address these concerns.

These are positive steps, but we need more physicians from the house of radiology to join the AMA and take part. Participation in the Current Procedural Terminology (CPT®) and the Resource Based Relative Value Scale /Relative Update Committee (RBRVS/RUC) process is dependent on AMA membership. So too is participation in the HOD’s legislative and policy making body work.
Radiology representation is vital. Representation is proportional to the number of AMA members in both organizations. The more radiologists who are members of the AMA, the more votes radiology has to speak for radiology on a host of issues, including Medicare and Medicaid payment, accountable care organizations (ACOs) and more.

To assure our place as content experts in radiology at the AMA, our membership in the AMA is crucial. Health care is changing. No one can afford to sit on the sidelines. That is why ACR, AMA as well State Medical Society Memberships (e.g., Medical Society of the District of Columbia) and involvement are so vital to advancing patient care, our practices and profession.