Radiology CAC Members Can Have a Big Impact

Sammy Chu, MD, FACR, Chair of the American College of Radiology® (ACR®) Contractor Advisory Committee (CAC) Network, and President of the Washington State Radiological Society contributed this post.

The Medicare Administrative Contractors, affectionately known as the MACs, are the medical insurance companies that actually process Medicare claims from physicians and hospitals. Medicare is such a large enterprise that the federal government contracts out these activities to the MACs, who can set coverage policies for their region called Local Coverage Determination policies, or LCDs. Back in 2019, there were changes to Medicare that provided a formal structure for the various MACs in the country to work together to develop these LCDs. The MACs have always had physician advisors— including radiologists — for their policies, meeting with each MAC in a state-level Contractor Advisory Committee, or CAC.  How would these CACs function on a national level?

In the first “cross-country” CAC, the topic of vertebroplasty and kyphoplasty was discussed. These spinal procedures involve the injection of bone cement into fractured vertebrae. After the MACs and CAC members met in a large national meeting at the beginning of 2019, it took several months before the LCD policies were written up … and it was a disaster. Payment for subacute fractures, which have always been covered and which the medical literature strongly supports, was suddenly stopped. It took several more months and numerous phone calls before these were put back on the payment list.

When your ACR CAC members learned that facet joint injections were to be discussed, we all held our breath. How would things turn out this time? The MACs and CAC members met (virtually, of course) in May 2020, and the literature on the efficacy of these injections for chronic facet pain was discussed. After several hours of heated debate, radiology CAC members were unclear what the new policy would look like. We only found out a couple of weeks ago, and the result was significantly better than the initial vertebroplasty result. The facet joint LCD was what we expected. However, these meetings have revealed upcoming challenges with the new LCD policy development process. The input of radiology CAC members has become diluted with these large national meetings, and more recently, even been shut out completely. The topics of discussion have focused on spinal injections, which form a relatively small portion of most radiology practices. What happens if the MACs turn their attention to imaging protocols? Fortunately, CAC members are still able to voice our concerns with the medical directors of each MAC, and that is how we need to exert our influence. It has never been more important to “act locally,” and we need to recruit engaged radiology CAC members for each state. If you are interested in influencing payment policy, please reach out to Alicia Blakey, ablakey@acr.org, or myself to get involved.

Please share your thoughts in the comments section below and join the discussion on Engage (login required).

A Note to My Future #RadRes Colleagues

Neil K. Jain, DO, IR/DR Resident at MedStar Georgetown University Hospital, and Chair of the American College of Radiology® (ACR®) Medical Student Subcommittee, contributed this post.

In today’s medicine, radiology is ubiquitous. From diagnosing pneumothoraxes on routine chest X-rays to detecting rare forms of renal cell carcinoma on contrast-enhanced ultrasound, radiology is intimately involved in solving many of medicine’s most complex problems. As a future radiologist, you are training to become experts with a unique skillset in imaging which will inevitably guide disease management and treatment.

Radiology is at the intersection of diagnostic and procedural medicine, groundbreaking innovation and patient-centered care. Imagine offering patients lifesaving interventions while maneuvering along the body’s intricate highway system through a miniscule pinhole. Diagnostic and interventional radiology are the future of medicine, and the future of medicine is here.

Each year on Match Day, our specialty continues to grow. Your investment and interest in joining the field of radiology is truly infectious. On behalf of the ACR Medical Student Subcommittee, and more than 40,000 members of the ACR, I would like to extend our warmest congratulations to you and your loved ones for your achievements. As you celebrate and prepare for the next step in your professional journey, we would like to welcome you into our family!

We’re here to support you as you take the next step in your career. Check out the ACR Medical Student Hub for countless resources, including toolkits, blogs, professional development and so much more.

Please share your thoughts in the comments section below and join the discussion on Engage (login required).

Taking Action to Achieve Health Equity

Johnson Lightfoote, MD, MBA, FACR, Medical Director of the Department of Radiology at Pomona Valley Hospital Medical Center, and Chair of the American College of Radiology® (ACR®) Commission for Women and Diversity, contributed this piece.

The World Health Organization defines health equity as, “The absence of unfair and avoidable or remediable differences in health among population groups defined socially, demographically or geographically.” Though the medical and technological advances of the 21st century have increased our life expectancy and healthy life expectancy, these developments impact our society unequally. As our underserved and underrepresented communities continue to face health inequities, how can we take action to narrow the disparity gap and ultimately eliminate these challenges?

To take meaningful action, we must first be able to recognize health disparities in the communities we serve. I’m pleased to invite you to attend the National Medical Association’s 2021 National Colloquium on African American Health. The webinar series will be held March 18, 20 and 27, 2021, and will focus on clinical, policy and social determinants of health and their impact on individual opportunities to earn a good living, live and work in a safe and healthy environment, and effectively use available social services and healthcare resources to optimize and maximize healthcare and disease prevention. I hope you’ll attend the free program.

In addition, the ACR 2021 Annual Meeting will feature a two-part CME course featuring Leading the Way to Health Equity. Be sure to join us May 17 and 18, 2021, for actionable discussions by national thought leaders.

Another great resource is the Understanding and Pursuing Health Equity: Opportunities to Take Action webinar. Experts from the American Medical Association (AMA) and the ACR share insight on how radiologists can take action against racial, socio-economic and geographical barriers to ensure quality care for all members of their communities. The free recording is available online and eligible for 1.5 AMA PRA Category 1 Credits.

Achieving health equity requires a collaborative effort of local, state and national leadership with the healthcare system. As radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians and medical physicists, we can make a difference — by taking action. I hope you’ll join me in the quest to achieve accessible, high-quality care for all.

Please share your thoughts in the comments section below and join the discussion on Engage (login required).