The Cornerstone of Radiology Economic Policy: Our Volunteers

The members of the ACR Commission on Economics make far-reaching contributions to health care.cornerstone

As the chair of the ACR Commission on Economics, I lead more than 700 devoted volunteers. This column allows me to thank these volunteers and invite more ACR members to join us.

Volunteering for our commission requires not only considerable time and energy but also extensive knowledge and expertise. And the requisite knowledge is not necessarily inherent or acquired through traditional degree programs. Most of it is on-the-job training, which can take years to procure. Even then, the rules and regulations change constantly. The effort is never-ending.

The work is professionally rewarding, and the positive contributions extend well beyond the ACR. Why are the contributions of our volunteers so far-reaching? Because socio economic policy is too complex for external policymakers and stakeholders to execute on their own. It is simply impossible for organizations, such as CMS, to maintain the clinical and policy depth knowledge necessary to complete their tasks, such as annually updating the Medicare Physician Fee Schedule.

So when CMS needs specialty-specific expertise, where does it turn? One source: the AMA, which contributes significant clinical resources. However, even the AMA cannot do it on its own. The AMA, therefore, turns to the specialty societies, including the ACR. The ACR helps provide the expertise, largely through our outstanding ACR staff. But even that is not enough. The ACR depends on its volunteer physicians and other professionals to carry the load. In a relatively rapid fashion, the call for help travels from CMS to our volunteers on the ground. From there, the information is efficiently fed back up the chain to CMS. It is a cycle that occurs continuously.

Here is a specific example. One of the ACR Commission on Economics' busiest positions is advisor to the AMA Relative Value Scale Update Committee (RUC), currently held by Kurt A. Schoppe, MD. The RUC makes recommendations to CMS regarding updates to the Resource-Based Relative Value Scale (RBRVS), a determinant of physician payment. Dr. Schoppe spent years observing the RUC, learning its language, and meeting the participants before his first trip to the table as the ACR alternate advisor to the RUC. Now that he is the advisor, he represents radiology before the RUC but on a broader level, and he helps the AMA and CMS with the RBRVS' constant evolution. In fact, the RUC is very different today than when Dr. Schoppe started. I could make similar observations and statements about several other important Commission on Economics' activities, such as Current Procedural Terminology, managed care, the Hospital Outpatient Prospective Payment System, and (a more recent focus) the Medicare Access and CHIP Reauthorization Act.

But our talented volunteers cannot do what they do forever. An important function is sharing knowledge with those who will succeed us as volunteers. Succession planning is critical to ensuring that our depth of talent endures. This is especially relevant for the technical tasks described herein. I believe that mentoring and transferring knowledge must be purposeful and expected of our volunteers. For them to be successful, recruiting new volunteers to assume these roles is critical.

The volunteers of the Commission on Economics dedicate their time, energy, and skills to advance our profession. Their contributions extend well beyond the ACR. I invite other ACR members to join us on the commission and help in this effort. To get started as a volunteer, visit Without volunteers, none of what I described in this column could occur as effectively as it does. Thank you to the volunteers who are the cornerstone of the ACR Commission on Economics.

dr silvaBy Ezequiel Silva III, MD, FACR, Chair

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