Your Board in Action
At its fall meeting, the ACR Board of Chancellors considered some of the most pressing issues confronting radiology.
The BOC and council steering committee (CSC) held their fall meeting Sept. 15–18, 2014. During the meeting, the College's leadership continued to focus on the future while responding to major challenges, including the Affordable Care Act, Medicare reimbursement and coverage decisions, lung cancer screening coverage, and decision support initiatives — a key part of Imaging 3.0™.
The meeting centered on approval of the ACR Strategic Plan, which has been in development over the past year. In addition, the BOC reviewed and approved financial reports.
Anne C. Roberts, MD, FACR, presented a review of the College's finances, emphasizing that while the ACR is financially sound, challenges within the profession resulting from health care reform may have financial implications. To better ensure long-term financial viability, the BOC approved a financial review framework for new BOC initiatives as well as a policy for funding disbursements from the ACR Foundation.
The ACR's strategic planning process was reviewed, highlighting the broad range of input from multiple stakeholder groups, including ACR membership and leadership. The board discussed the new plan in detail and adopted it with minor changes. The plan includes a new core purpose statement (illuminating why the ACR exists) and new organizational values (essential enduring principles that will help guide future behavior in the organization). In addition, the plan envisioned the future of the College through its vision and description statements. The goals and objectives provide greater detail of the desired outcomes and measureable milestones needed to assess and measure the plan's progress over time. Presentation of the plan, discussion, and brainstorming of strategies followed. The next steps will include key program assessment and strategic plan alignment with results presented at the BOC meeting in January.
Keeping the focus on strategic challenges facing the profession, we developed the Scenario and Wicked Problem Action Group (SWAG), chaired by Frank J. Lexa, MD, MBA. This group will be developing strategic issues for board consideration at future BOC meetings. The first strategic session addressed the following questions: Should the major professional organizations in radiology move to develop strong alliances that include reduction of redundant programs? What are the implications for U.S. radiology of a reduction in dues-collecting, meeting-organizing, and journal-producing entities? BOC and CSC members were split into teams to consider the pros and cons of the issue using non-specific organizations. Each team reported back its experiences and challenges faced during negotiations.
We discussed our clinical decision support initiatives, noting the successful workflow integration of ACR Select™ in the major electronic health records. James A. Brink, MD, FACR, and Debra L. Monticciolo, MD, FACR, provided a description and overview of a Quality Management Framework designed to provide members with workflow integrated, point-of-care tools to document quality and value. Keith J. Dreyer, DO, PhD, FACR, reviewed four informatics initiatives that will help move our Imaging 3.0 initiative into clinical practice: 1) workflow enhancements to our clinical decision support tool (ACR Select); 2) a mechanism for computer-assisted radiology (ACR Assist), which will help us bring evidence-based guidelines for recommendations and actionable reporting into clinical practice;3) a standardized core set of terminology to enhance communication among informatics initiatives and with external informatics products (ACR Common); and 4) enhancements to our image transfer framework (ACR Connect®) that will help extend TRIAD into clinical practice. Geraldine B. McGinty, MD, MBA, FACR, gave the board an overview of culture shift initiatives within the Imaging 3.0 strategy, including individual visits to practices for a one-on-one support and analysis.
Carolyn C. Meltzer, MD, FACR, reported on the transitions related to the Commission on Research, including its three main initiatives: ACRIN®, the Harvey L. Neiman Health Policy Institute™, and the Head Injury Institute™.
Gerald D. Dodd III, MD, FACR, reported on the Intersociety Summer Conference, which was held July 25–27, 2014, in Santa Fe, N.M., with the theme of "Reengineering the Radiology Enterprise."
David C. Kushner, MD, FACR, chair of the Commission on Membership and Communications, acknowledged the challenges related to membership but emphasized the importance of providing a continuum of services that address members' needs throughout their careers. Andrew Moriarity, MD, provided a Resident and Fellow Section (RFS) update as part of the membership presentation.
Additionally, the BOC heard brief updates from the 21 ACR commission chairs (who serve on the board) as well as reports from the CSC, the Radiology Advocacy Network, the Radiology Leadership Institute®, the JACR®, the Canadian Association of Radiologists, and the Task Force on Interventional Radiology.
Cheri L. Canon, MD, FACR, reviewed ACR 2015 meeting highlights, including over 100 education sessions with 151.5 hours of educational content, 31+ hours of continuing medical education credits, and 47 sessions that will offer self-assessment credits.
Katarzyna J. Macura, MD, PhD, FACR, provided an update on the Commission on Women and General Diversity. The commission has been focusing on establishing a baseline of information on the current representation of the profession and members within the organization.
Separately, the Board of Directors also heard updates from the American College of Radiology Association on economics and government relations. I reported RADPAC® contributions of over $900,000 to date, noting the importance of these special fundraising efforts. Of the more than 100 health care PACs, RADPAC continues to rank in the top three both in contributions raised and contributions made to members of Congress. Despite this good news, only 12 percent of members currently give to RADPAC.
Cynthia Moran, executive vice president of government relations, economics, and health policy, provided a legislative update. Moran noted that the Democrats stand poised to gain back Senate seats in 2016 given the significant number of Republican seats that will be defended and the larger voter turnout anticipated compared with the November 2014 elections. ACR's legislative agenda for the 114th Congress will include a permanent repeal of the sustainable growth rate, countering radiology benefit managers' efforts to amend and insert changes to the clinical decision support provisions in the SGR patch law, and any legislative effort to single out diagnostic imaging for payment reductions. Legislation will also be pursued to repeal the multiple procedure payment reduction policy if the CMS fails to reveal the data to justify the multiple procedure payment reduction policy.
Geraldine B. McGinty, MD, MBA, FACR, chair of the Commission on Economics, provided an update on critical issues included in the Medicare Proposed Rule and the Physician Fee Schedule changes in coding. She also assessed progress on receiving the data CMS used to justify the multiple procedure payment reduction. Bundling and packaging of services in the Hospital Outpatient Prospective Payment System continues to be an important initiative for CMS, and McGinty provided an update and risk assessment for site neutral payment initiatives and discussed why physicians are paid differently for the same service in different practice settings. Updates on new payment models were highlighted, noting the importance of metrics. McGinty concluded by reporting that there are major risks ahead for breast imaging and, although we are in a challenging environment, the ACR continues to anticipate and lead on developing solutions to those challenges.
By Bibb Allen Jr., MD, FACR, Chair