Does Your Scan Reflect R-SCAN?

This post was contributed by Gregory N. Nicola, MD, FACR, chair of the ACR Economics Committee on MACRA.

Nicola_GYes, this blog’s title is tongue in cheek. But the question is important.

It’s important if you’re participating in the Merit-based Incentive Payment Systems (MIPS) component of the Centers for Medicaid and Medicare Services (CMS) Quality Payment Program (QPP).

Radiologists and collaborating referring doctors may earn seven medium-weight Improvement Activity (IA) credits for completing a Radiology Support, Communication and Alignment Network (R-SCAN) project this year. With one R-SCAN project, both radiologists and referring clinicians may meet all of their IA requirements to achieve MIPS credit.

More than 150 radiology practices — from small private practices to large academic centers — and referring practices are participating in R-SCAN to meet IA requirements. You need to show activity engagement for 90 consecutive days. So, there’s time for you to get started this year.

Taking part in R-SCAN brings radiologists and referring clinicians together to improve imaging appropriateness based on Choosing Wisely topics.

It prepares you for the coming federal mandate that health care providers consult appropriate use criteria before ordering advanced imaging for Medicare patients. It gets referring doctors familiar with clinical decision support technology at no cost. R-SCAN participants gain free access to a customized version the ACR Select® CDS tool, the web-based version of the ACR Appropriateness Criteria®.

And, you and referring doctors can get complimentary CME credit.

More information can be found on the R-SCAN website, including the how-to guide, topics, general resources, topic-specific resources and FAQs.

R-SCAN shows our commitment to providing value-based care. Others can see our efforts to improve quality, reduce low-value scans and lower imaging costs, which are essential under advanced payment models. It’s time to get started with R-SCAN.

If you’re participating in R-SCAN, tell us about your project.

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

Is the Future of Radiology Diversity, Acceptance and Mutual Understanding?

This post was contributed by Amy Patel, MD, breast radiologist, Beth Israel Deaconess Medical Center, Boston, Mass.

Patel_AmyI consider myself the eternal optimist. I am also a realist regarding the differing opinions of the fabric of our society and how difficult these discussions can be.

However, it’s an indisputable fact that diversity is proving to be invaluable in the business world and other arenas in the United States.

  • In fact, according to a Forbes study of 321 executives in companies that grossed $500 million or more annually, one of the “key findings” was that “Diversity is a key driver of innovation and is a critical component of being successful on a global scale.”
  • McKinsey Global Institute reported that fostering women’s equality can potentially add $12 trillion to the global gross domestic product by 2025.
  • It is projected that by 2055 the United States will no longer be comprised of a majority regarding race or ethnicity.

Consequently, we as radiologists will be serving a diverse patient population. We will need to be prepared to meet the needs of our patients, including arriving to mutual understanding to better serve them.

The recent ACR Intersociety Summer Conference focused on the subject of diversity and inclusion, including devising action plans ranging from creating a pipeline to recruit female and underrepresented minority medical students into radiology to potentially implementing programs at institutions across the country that support our patients and fellow colleagues.

Remarkably, we are seeing a shift in perspectives regarding diversity in millennials as this topic was considered “the new norm” — reinforced during the meeting both by attendees and on social media. As a millennial, I feel more accustomed to welcome any patient demographic, as this is all my generation has ever really known, largely beginning from our training in medical school; Inclusion is second nature in many instances.

I acknowledge that we must not overgeneralize regarding one generation versus another, but we can certainly learn from one another if we keep the discussion going and are willing to be empathetic toward one another’s viewpoint. Additionally, we must not forget that the spectrum of diversity includes additional social constructs that we must embrace, including late-career colleagues and colleagues with disabilities.

As we look toward the future, we must provide resources to better educate radiologists at all levels of training to enrich our profession to be a successful, vibrant and, most importantly, an inclusionary one.

  • How are you preparing to meet the needs of a diverse patient population?
  • Do you think attitudes toward diversity differ based on generation? If so, how do you think it will affect radiology in the future?

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

New IDEAS for Alzheimer’s Treatment

This post was contributed by Barry A. Siegel, MD, FACR, professor of radiology at Washington University, St. Louis, MO; co-chair of the National Oncologic PET Registry (NOPR); and co-chair of the IDEAS (Imaging Dementia—Evidence for Amyloid Scanning) Study.

SiegelBarry_MD_2_6x9In 2009 and 2013, CMS expanded coverage for PET for clinical applications in oncology. This was due, in part, to the successful evidence-based research from the National Oncologic PET Registry (NOPR).

Radiologists played a leading role in working with CMS in setting up that national registry that allowed for expanded access to PET.

Similarly, radiologists are playing a lead role with the Imaging Dementia—Evidence for Amyloid Scanning (IDEAS) study.

The IDEAS Study will follow nearly 19,000 Medicare beneficiaries to determine the clinical value of a PET scan to detect the hallmark brain amyloid accumulation of Alzheimer’s disease in diagnosing and managing treatment in patients ages 65 and older with mild cognitive impairment (MCI) or dementia of uncertain cause. It’s being carried out by more than 500 referring physician practices and 300 PET imaging facilities in the United States.

IDEAS is a national CMS-approved coverage with evidence development study being funded and managed by the Alzheimer’s Association and the ACR. The sources of funding for these organizations include their own funds, support from the three industry vendors of FDA-approved amyloid imaging agents (Eli Lilly and Company, GE Healthcare and Piramal) and from the fees that will be paid by participating PET facilities. Medicare will be paying for the PET scans as a covered service.

Early findings show that amyloid PET scans can have a large impact on how Alzheimer patients are managed. These results were released during the Alzheimer’s Association International Conference in July.

Among the first 3,970 enrolled patients, clinical management changed in nearly 68 percent with MCI and nearly 66 percent of those with atypical dementia. The PET scans prompted adjustments in Alzheimer’s drugs and related medications, as well as counseling recommendations.

Gil Rabinovici, MD, the IDEAS Study principal investigator and associate professor of neurology at Memory and Aging Center, University of California, San Francisco (UCSF), had expected the early findings to show amyloid PET scans might change medical management in 30 percent of cases. Personally, I’m encouraged that the final trial results will show that this technology may make a real difference for patients.

The hope is that strong positive results like these will encourage CMS and private insurers to cover the scans in the future.

  • Based on these initial results, do you believe that CMS and other third-party payers should cover amyloid PET scans?

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