In Case You Missed It: Highlights From the ACR Resident and Fellow Journal Club Meeting
An ACR Resident and Fellow Journal Club meeting was held in April 2017. The focus featured a topic important to both radiologists and radiation oncologists... reimbursement.
Our featured guest, Najeeb Mohideen. MD, FACR, from Northwest Community Hospital in Chicago, spoke on the topic of medical reimbursement. The program was titled Letters and Numbers — Reimbursement in Radiation Oncology. Mohideen has been intricately involved with upcoming changes to Medicare reimbursement, particularly the proposed Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) changes. He has had extensive engagement in both the American Society of Therapeutic Radiation Oncology (ASTRO) and the ACR. In the ACR, he is a current member of the Managed Care Committee and the Commission on Radiation Oncology. He has had distinguished roles on the ACR-ASTRO joint economic council and ASTRO committee on radiation oncology coding and code utilization, as well as being a past advisor for the relative value update committee, which is responsible for valuing physician work for new and revised CPT® codes.
Part of Mohideen’s presentation was a review of a recent article exploring Variations in Medicare Reimbursement in Radiation Oncology: An Analysis of the Medicare Provider Utilization and Payment Data Set, authored by John Robertson, MD, and his colleagues in the Beaumont Health System in Royal Oak, Mich. This analysis was recently published in the International Journal of Radiation Oncology, Biology, and Physics, and summarized data on Medicare technical service reimbursement to radiation oncologists. In this study, the data was analyzed based on differences in billed level of service for new and established patients (E&M codes), practice locality, and provider gender. Overall, the presentation provided a nice perspective of practice trends across a variety of providers. We learned that simply using technical reimbursements cannot be the sole tool to compare specialties, and that Medicare records do not tell the entire reimbursement story. This is an important point that should be remembered when thinking globally about radiology and radiation oncology reimbursements.
By Bryan Rabatic,MD, past radiation oncology liaison and radiation oncology resident, University of North Carolina School of Medicine, Chapel Hill