2011 ACR Update
Howard Fleishon, M.D., Valley Radiologists and Medical Director at John C. Lincoln North Mountain Radiology.
ACR organizational structure was given with Arizona’s connections delineated. Arizona has had good representation at the ACR Council Steering Committee including representation in the past from Drs. Crowe, Levi, Owen and Ovitt.
ACR Nationally
Economic Realities of Radiology
Reimbursement policies in Washington D.C. are going to affect imaging. Specific areas government is looking at include ACA implementation (Obama-care), Self-referrals, and USPSTF reform particularly in mammography.
Viewpoint of the MEdpAC
A policy advisory group the MedpAC provides advisory services to CMS. It is the model that formed the basis for the Independent Payment Advisory Board created by the APA. Dr. Fleishon presented thinking behind MEdpAC’s recommendations as follows:
· Industry data on imaging is showing a decrease of 7.1% volume, MEdpAC is reporting an increase of 2% volume.
· Bundling of services/billing codes to create reductions in reimbursement; particularly reductions for multiple body parts seen the same day.
· Government is determining billing codes, formerly this was the purview of the AMA
· Up to 50% reductions for same-day utilization of a second imaging modality
· CMS is examining the feasibility of prior authorization for advanced imaging services
· According to MEdpAC the top 10% of physicians account for 50% of imaging orders
ACR Response to these pressures
· Economics Commission submitted comments. Organized grassroots advocacy effort.
· More cuts are expected to medicine in general and radiology in particular to meet the goals of government debt reduction.
· The super-committee (Jon Kyle is a member) in Washington, formed to find savings, needs to be lobbied about how these changes will affect health care
ACR Locally
The Maryland law is being held up in courts, limiting self-referral for advanced imaging.
Radiology assistants (Arizona is one of 29 states allowing practice). H.R. 3032 addresses reimbursement and ACR supports this bill
Scope of practice issues –
Iowa – board of nursing allowed nurses to perform fluoroscopy
New Mexico – Nurse practitioners are allowed to perform any imaging exam.
contributions to legislatures has increased from just over $500,000 in 2005 to $1,211,477 in 2010. RADPAC contributions on a percentage basis are high for medical professional organization but lower than other lobbying groups.
Through RADPAC, imaging centers can arrange for site visits by congressmen to see radiology departments and learn more about the work we perform. For more information, contact Ted Burnes tburnes@acr.org this will allow legislators to spend approximately 1 – two hours touring and discussing work in the imaging center. RADPAC can arrange the details and logistics of the site visit and in selected cases will supply funding for campaign contributions.
ACR Advocacy Committee:
New effort to optimize national and encourage local efforts at grassroots advocacy. In Arizona, Dr. Fleishon recommends that we coordinate the resources of all imaging constituents in order to have an effective voice.
ACR Quality and Safety
· Accreditation
· Practice guidelines and technical standards
· ACR National Radiology Data Regulations (NRDR)
o Monitoring CT dosage
“Image Gently”
“Image Wisely”
ACR Education Center
Opened March 2008
ACR Research
ACR clinical research center ~50% ACR budget and staff
ACRIN-ACR Investigative Network
RTOG Radiation Therapy Oncology Group
Other Resources
JACR – practice applications. Practiceleaders.acr.org
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