MACRA: Show and Tell (Me)

This post contributed by Ezequiel Silva III, MD, FACR, chair of the American College of Radiology Commission on Economics.

Dr. SilvaHealth care delivery payment changes are here. The Medicare Access and CHIP Reauthorization Act (MACRA) authorized Quality Payment Program and federal clinical decision support requirements are changing how radiology care is ordered and carried out.

The ACR has committed to not only tell us about these changes, but offer multiple resources to help us make the leap to value-based care. In fact, whenever possible, ACR has hands-on resources to show us exactly how to do it.

One of those opportunities is coming up. The ACR, in cooperation with the American Medical Association (AMA) and the Illinois Health & Hospital Association (IHA), is hosting a Sept 7 event in Chicago (register here) to give referring physicians and radiologists hands-on experience with new tools and training to help physicians improve quality and outcomes by ordering more appropriate imaging.  If you can’t attend the AMA’s STEPS Forward Practice Improvement Strategies: Clinical Decision Support for Imaging, you may register to be notified when the videos from the event are posted online.

This event offers value for clinicians who order radiology exams (e.g., internal medicine, pediatrics, and emergency medicine), radiologists and other medical imaging professionals, as well as quality officers, CMOs, CIOs, and CEOs, members of Practice Transformation Networks and other quality-based healthcare organizations.

These events and resources—made possible in-part through ACR’s R-SCAN™ and Imaging 3.0™ initiatives—are part of radiology’s seat at the table to impact health care reform. They also offer free CME opportunities for radiologists to help themselves and their practices make informed decisions as medicine transitions from volume- to value-based care.

I can’t urge you enough to take advantage of these resources (particularly the upcoming Chicago event). I would also be greatly interested in hearing how you and your practice are working to Be MACRA Ready.

Please share your experiences and thoughts in the comments section below.

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Fighting for Gold With CT Colonography Coverage

The following post was contributed by Judy Yee, MD, FACR, chair of the American College of Radiology (ACR) Colon Cancer Committee.

Dr. YEEIn these last days of August, besides cheering the efforts of our athletes at the Olympics in Rio, let’s salute the American College of Radiology (ACR) officers, volunteers and staff in their continuing effort to obtain Medicare coverage for CT colonography (CTC) to advance patient care.

With colorectal cancer patient advocacy groups and related medical associations, ACR urged the Centers for Medicare & Medicaid Services (CMS) in a national coverage determination reconsideration request letter to recognize CTC as a recommended test for colorectal cancer (CRC) screening for adults ages 50–75 as a screening benefit under Medicare.

United States Preventive Services Task Force (USPSTF) screening recommendations assigned the highest rating, an “A” grade, to CRC screening, including virtual colonoscopy and other tests. Under the Affordable Care Act (ACA), this “A” rating would require insurers that take part in insurance exchanges to cover virtual colonoscopy without patient cost sharing. While Medicare is not bound to provide coverage under the ACA, we believe that Medicare should cover seniors for these exams.

The best colorectal cancer screening exam is the one that a person ultimately chooses to use. Too many are dying from a largely preventable disease that can almost always be treated if found early. Medicare coverage of CTC would ensure access to a proven screening method for those who cannot, or will not, have a traditional colonoscopy. CTC increases screening rates for seniors, which can save lives, and lowers costs.

Like elite athletes, our dedicated volunteers and staff understand the needed strategies, working as an integrated, agile team who dedicate enormous advocacy and public relations resources to make a significant difference in the lives of patients. ACR defends and advances our causes and offers  needed online CTC resources to educate our patients.

We continue to move toward that Olympic Gold Medal moment—with the medals podium in sight—when Medicare covers screening CTC.

You are pivotal to the success of ACR efforts. Please let us know:

  • Does your facility offer CTC now?
  • If you do not currently offer CTC, do you plan to offer it within the next year?
  • Do you want more CTC training opportunities?

What’s the Radiology Job Outlook?

This post was contributed by Edward I. Bluth, MD, FACR, chair of the ACR Commission on Human Resources.

Bluth_EdwardThe 2016 ACR Commission on Human Resources Workforce Survey results are out, offering a forecast regarding job opportunities and reflecting an overall positive outlook for radiologists.

There’s a greater availability of job opportunities compared with previous years, and the projected number of radiologists to be hired this year shows a 16.2 percent increase from last year’s hiring. Adding to this, the survey noted that 55 percent of the jobs were for first-time hires (post training) and 45 percent of jobs were obtained by radiologists moving from another job in 2015.

By Gender?

Male radiologists (78.6 percent) continue to outnumber female radiologists (21.4 percent). However, the survey did show that a larger number (26 percent) of radiologists younger than 45 years are women indicating an increased percentage of women radiologists in younger age groups. Unfortunately, this percentage doesn’t reflect the percentage of women enrolled in medical school. The Commission on Human Resources is studying the issue of why medical students chose radiology as their specialty, and the Commission on Women and Diversity is examining ways to attract more women into the workforce.

Where Are the Jobs?

It’s estimated that there will be 1,713–2,223 jobs available this year. The most plentiful jobs will be in the Midwest and the South—and in private practice (54 percent) followed by academic and university practices (29 percent).

Where Do I Fit in This Picture?

The current workforce shows radiologists in these practice areas: private practice (57 percent); academic/university settings (12 percent); hospital (12 percent); and multispecialty clinics (8 percent); corporate and/or government environments (.4 percent or less). While 85 percent of radiologists work full time, women account for more part-time work (30 percent), as compared to their male counterparts (9 percent).

Most Needed Subspecialties?

The most needed subspecialties are breast imaging (14 percent); general interventional (13 percent); neuroradiology (12 percent); general radiology (11 percent); body imaging (11 percent); and musculoskeletal subspecialties (10 percent).

The survey appears in the Journal of the American College of Radiology (JACR) and has been published annually since 2011.

How do you view the current radiology job outlook? Have you been hearing about more job opportunities?