The following post was contributed by Geraldine McGinty, MD, MBA, FACR.
The American College of Radiology (ACR) wants member guidance for involvement in new Centers for Medicare & Medicaid Services’ initiatives to adopt value-based reimbursement and alternative payment models defined by the Medicare Access and CHIP Reauthorization Act.
In a recent message, Bibb Allen, Jr., MD, FACR, chairman of the ACR Board of Chancellors, announced efforts that will lead to development of radiology-specific quality metrics for Medicare’s new Merit-based Incentive Payment System (MIPS) and imaging friendly Alternative Payment Models (APMs).
I want to share a little more about the College’s plans, especially regarding a survey many of you have received to launch the overall effort. Below are answers to basic questions regarding this landmark effort.
Why is the ACR beginning this process with a survey?
We want to emphasize this will a College-wide effort. We know people are doing innovative things, and we want to make sure this is made part of our effort. We want members to feel that they are part of this process and that their voices have been heard. We will be taking the input we get and using it to influence the proposal we bring to Medicare. We also want to be sure our proposals are applicable to different parts of the country and different types of practices.
What does the ACR hope to learn from members who have experience with APMs?
We do actually have a connection with the broader membership regarding integrated care and new payment models through our existing committees, but we felt it was important to cast a wide net just in case there are people who have success stories in whatever type of payment system we can learn from. Hopefully when Medicare implements the recommendations, there won’t be people who believe a particular metric or alternative practice model is not relevant to them. We want to consider our entire membership and all of our constituencies as we think about these measures.
To what extent will Medicare’s new MIPS and APMs affect radiologists and their practices?
By 2022, approximately nine percent of Medicare payment will be at-risk for participation in the MIPS program. In parallel, five percent of value-based payment will be associated with participation in an alternative payment model. We really don’t know yet what that will mean for radiologists, and we don’t have a significant role in determining what that means, but we are talking about a significant number of dollars. The other important part of it this is that Medicare is aiming toward working more closely with commercial payers. Commercial payers are looking for more value-based payments as well. We should expect these programs will extend their reach beyond Medicare.
How does the ACR plan to help radiologists prepare for implementation of Medicare’s MIPS program and the potential opportunities associated with their participation APMs?
We will be developing new models that reflect the nature of quality imaging and drive improved care. The first thing we are doing is trying to make sure that by being actively engaged in this process we will be driving it. We will keep members informed about changes to the programs as they evolve. Once we have a clear sense of what the programs will be, we will continue our approach that we started with the Qualified Clinical Data Registry to support our members and to make sure participation is as easy as possible. We will make sure our educational efforts help our members to get paid appropriately as these new value-based reimbursement system come online.
Why is it important for the ACR to play a role in defining radiology quality metrics and actually building APMs that are appropriate for its members?
Because nobody knows as we well as we do what quality imaging means and how to effectively use quality imaging appropriately. We have a unique skill set and voice in that discussion.
How can ACR members join with the College in this process?
I would really urge everyone who receives a survey to complete it. Tell us your stories. If you can’t explain your story in the survey, then give us your email address and phone, and we’ll follow up. We want to hear from you.