What’s the Big Picture on the Anthem Imaging Policy?

Brink Headshot JPGThis post was contributed by James A. Brink, MD, FACR, chair of the ACR Board of Chancellors.

Soon you will receive in the mail a print copy of my latest JACR column explaining why the ACR opposes recent Anthem outpatient imaging policies and why this action supports all radiologists and our patients.

There is some confusion among members on the ACR stance. The College wants you to see our rationale as soon as possible.

Anthem now bars many beneficiaries from getting advanced imaging in hospital outpatient departments. Modern Healthcare recently reported how these policies can disadvantage patients for whom hospitals provide their desired or most convenient access to imaging exams.

Anthem has accelerated a reimbursement race to the bottom that threatens our ability to offer care in all locations that patients may want to receive it. That is why the American Medical Association (AMA) and a growing number of patient groups oppose the Anthem policy.

The ACR is not taking sides in the marketplace (hospital vs. freestanding radiologists). The ACR would equally oppose a reverse steerage policy that arbitrarily moved patients from independent imaging centers to hospital-based facilities.

Whether you practice in a hospital-based or independently owned facility, this insurer-driven steerage is detrimental to you and your patients. That is why the ACR opposes it.

Please keep an eye on your mailbox for the ACR letter and on your inbox for further updates from the College on this vitally important issue. We need to stand united.

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Veterans Day and the Voices of Radiologists that Serve

Ian Weissman 3336 EThis post was contributed by Ian A. Weissman, DO, Team Lead VA Workgroup GSER Commission, radiologist at the Milwaukee Veterans Affairs Medical Center.

On the recent Veterans’ Day, Americans honored and expressed their deepest thanks and gratitude to our Veterans for their service.

The U.S. Department of Veterans Affairs (VA) is the nation’s largest integrated health care system. Many radiologists serve through the VA, which seeks to fulfill President Lincoln’s promise:

“To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s Veterans.

We, as radiologists, are actively involved in improving veteran and patient care. ACR resources are available to help. The ACR General, Small, Emergency, and/or Rural Practice (GSER) Commission has developed a VA Workgroup spearheaded by Bob Pyatt, MD, FACR and Eric Friedberg, MD, FACR. The workgroup engages VA and non-VA radiologists to promote shared knowledge and experiences to strengthen the ACR and VA.

The ACR’s Engage platform hosts a forum called “VAROCKS” (ACR login required) to allow VA physicians to exchange ideas and find solutions to common problems. If you have interest in contributing to this effort, please join the VAROCKS forum on Engage.

In a future article, the voices of ACR-VA workgroup members, Tahira Ahmed, MD; J. Michael Holbert MD, FACR, Jennifer Nathan, MD; Amilcare Gentili MD, FACHE; and John Nichols, MD, all with a shared commitment to service and patient advocacy, will be heard. Michelle Dorsey’s MD work was featured in a recent ACR Bulletin article on Military and VA.

Mike Donner, MD, FACR and myself developed an educational program for the ACR 2018 annual meeting that will discuss the many opportunities for VA and non-VA radiologists to get involved at the local, state and national level. Bob Sherrier, MD, the Chief Consultant of Diagnostic Services at the Veterans Health Administration will share his thoughts.

Please reach out to me or my colleagues personally, or through VAROCKS if you would like to get involved in this new landmark ACR-VA initiative.

Your voice is important. Your ideas and experience are valued.

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

 

 

Lung Cancer Screening and Awareness Save Lives

This post was contributed by Ella Kazerooni, MD, FACR, chair of the American College of Radiology Lung Cancer Screening Committee and ACR Thoracic Imaging Panel.

Ella KazerooniIt’s been more than two years since Medicare’s decision to cover low-dose CT lung cancer screening for older current former heavy smokers. Yet, access to this test hasn’t grown as hoped.

Lung cancer screening can save more lives than any cancer screening test in history. It is important that we continue to educate referring providers and patients about this lifesaving exam.

For our practices, the primary obstacle is Medicare reimbursement. Under HOPPS, Medicare only pays about $60 per scan. Payment under the MPFS is double that amount. This helps. We are working toward sensible reimbursement while we educate.

November’s Lung Cancer Awareness Month  provides the perfect opportunity to raise awareness and increase attention to the benefits of screening.

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  • The ACR Lung Cancer Screening resources page offers a number of materials to help us spread the word and learn how to instill safe and effective lung cancer screening programs in our practices or hospitals
  • I would also invite you to check out the American Lung Association Saved by the Scan campaign. This may be a useful resource for you to link to from your practice website.
  • RadiologyInfo.org is another tremendous resource for patients. The lung cancer screening section explains to patients what lung cancer screening exams are, how to prepare for them, benefits and risks, and more.

We have tools available to us to educate our referring providers and patients about lung cancer screening and how it can help many high-risk patients.

I invite you to use them. There is no better time to start than now.

What are the elements of your successful lung cancer screening program?

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