Published on the Feb. 16, 2012, DiagnosticImaging.com website
By Whitney L.J. Howell
Throughout 2011, most chatter in radiology centered around how healthcare reform would change the industry or how practitioners should manage and use newer modalities. In a look ahead at the next 12 months, many industry luminaries anticipate the same concerns will linger on the horizon even as new ones appear.
Some of the upcoming challenges touch the individual radiologist’s pocketbook; others affect practice. Regardless of the specifics, radiologists will do well to revamp how they view themselves as part of the healthcare system, said James Thrall, MD, Massachusetts General Hospital (MGH) radiologist-in-chief and former American College of Radiology president.
Radiology’s biggest concern for 2012 is a holdover from last year — bundled payments and reduced reimbursement. Under the proposed accountable care model, radiology reimbursements would be wrapped up in a lump-sum amount that includes facility, physician, and technical payments.
It’s the ambiguity of these packaged payment’s impact that make them the industry’s greatest challenge this year, said, Leonard Berlin, MD, former chair of the professionalism committee with the Radiological Society of North America (RSNA).
“There’s no question that there’s been a definite move to decrease reimbursement for radiology at the Centers for Medicare and Medicaid Services,” Berlin said. “All the projections for radiology reimbursement have it falling, meaning that practitioners, for 2012 and beyond, will need to find a way to maintain and manage a workload that is sometimes heavier for less money.”
The ACR is also concerned about reduced payments. Currently, the organization’s No. 1 priority is working with Congress to extend the temporary fix to Medicare’s sustainable growth rate, the formula used to control healthcare spending. The stop-gap measure, enacted in December 2011, averted a 27 percent physician payment reduction, and the ACR would like to extend the fix permanently.
“We’re also watching carefully to see if we can stop the Centers for Medicare and Medicaid Services from making any multiple procedure payment reductions,” said Cindy Moran, ACR’s government relations assistant executive director, referring to cuts in payment when two or more codes are performed to the same patient by the same physician during a single session. “But we are also assuming, with this being an election year, that we might be faced with a lame duck Congress.”
Changes could also be coming to codes that routinely appear together, said Maurine Spillman-Dennis, ACR’s senior director of health policy. CMS is analyzing whether procedure codes that are often linked 50 percent, 75 percent, and 90 percent of the time can be bundled, reducing overall reimbursement for those services.
“We are involved in an evolution toward a new payment model. The bottom line is that healthcare is turning away from the fee-for-service system and moving toward capitated services,” Spillman-Dennis said. “It will be a challenge for radiology to fight under this new care delivery model and make sure its practitioners are paid for services provided.”
To read the remainder of the article: http://www.diagnosticimaging.com/practice-management/content/article/113619/2033254
February 16, 2012 Posted by wljhowell | Healthcare | American College of Radiology health policy, American College of Radiology lobbying over sustainable growth rate, challenges to radiology in 2012, changes in radiology in 2012, Cindy Moran, dense breast tissue legislation, drop in radiology malpractice suits, financial challenges to radiology, growth of telemammography, in-house radiologists fight against teleradiology, increased attention to CT dose levels, informing patients about dense breast tissue, James Thrall MD, leadership programs for radiologists, Leonard Berlin MD, Mammography Quality Standards Act, Maurine Spillman-Dennis, Medicare sustainable growth rate, mock radiology malpractice trial, practice challenges to radiology, Radiological Society of North America, radiology concerns about cloud computing, radiology concerns over bundled payments, radiology increased focus on CT scans, radiology worries about bundled codes, temporary fix to Medicare's sustainable growth rate | Leave a Comment
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I’m a seasoned reporter, writer, freelancer and public relations specialist with a master’s degree in international print journalism from The American University in Washington, D.C. I launched my journalism career as a stringer for UPI on Sept. 11, 2001, on Capitol Hill. That day led to a two-year stint as a daily political reporter in Montgomery County, Md. As a staff writer for the Association of American Medical Colleges, a public relations specialist for the Duke University Medical Center and the public relations director for the UNC-Chapel Hill School of Nursing, I’ve earned in-depth experience in covering health care, including academic medicine, health care reform, women’s health, pediatrics, radiology, and Medicare.
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