Year in Review
Here are the hot items on a broad range of topics from 2017, according to the ACR Q&S team.
As the Quality Payment Program (QPP) moves into its second year, CMS has issued updates to describe the implementation of the program in 2018. The proposed changes continue to provide flexibility to help clinicians participate and gradually prepare for full implementation. The final rule is expected to take effect Jan. 1, 2018. See the December Inside Quality and Safety eNews for updates at www.acr.org/Quality-Safety/eNews.
Some of the proposed features of the QPP:
1 "Pick Your Pace" phases out after 2018. Under the first two years of the QPP, physicians had the ability to participate to any extent they could. CMS will continue phasing in full Merit-Based Incentive Payment System (MIPS) requirements anticipated in the 2019 performance year.
2 Small and rural practices receive bonus points to ease transitions. CMS included proposals to further ease the transition to the QPP for small and rural practices, including receiving five bonus points for participating in a small group practice.
3 The performance period for the quality and cost performance categories will now be a full year: CMS proposes increasing the performance period requirements to be a full calendar year for the quality and cost performance categories (for at least 50 percent of patients).
4 Individual MIPS-eligible clinicians will be able to submit data on measures and activities via multiple data submission mechanisms for a single performance category to meet the requirements of the quality improvement activities. Previously, MIPS-eligible clinicians were required to use only one submission mechanism per performance category. This proposal will allow clinicians and groups the ability to select the quality measures most meaningful to them, regardless of submission mechanism: claims, qualified registry, or qualified clinical data registry.
Additionally, the ACR is encouraging radiology practices to forge new pathways to practice success through value-based quality improvement. Begin by acknowledging that payment and quality are more strongly linked than ever before. Take advantage of all of the resources that the ACR makes available to members to help you learn, prepare, and take action for success under the Medicare Access and CHIP Reauthorization Act of 2015 and QPP.
The ACR Radiation Oncology Practice Accreditation (ROPA) program has implemented a new electronic final report process. For radiation oncology facilities, the streamlined system means the accreditation process will be easier and faster, with turnaround times for the final report often cut in half. The ROPA program updated the electronic application for facility users, making it easier to submit physics quality assurance data for external beam treatment machines.
The new Interventional Radiology Registry, a collaboration between the ACR and the Society of Interventional Radiology and a part of the National Radiology Data Registry (NRDR®), is designed to further quality care for patients undergoing interventional radiology (IR) procedures. The IR Registry will also give participants additional opportunities to fulfill requirements for various quality reporting initiatives, including MIPS. Register your facility with the NRDR, and access a list of all IR quality measures that are available for reporting on the IR Registry (bit.ly/IRRegistry).
Breast Imaging and the FDA
Under Mammography Quality Standards Act (MQSA) Final Regulations the FDA inspects every mammography facility yearly. The Enhancing Quality Using the Inspection Program (EQUIP) has added three additional questions to the inspection process. Access EQUIP resources, including informational videos, documents, and MQSA insights articles at bit.ly/EQUIP_Program. The ACR has also updated its frequently asked questions on the 2016 ACR Digital Mammography Quality Control Manual Resources web page (available at bit.ly/digital_mammo) to show how using the optional Radiologist Image Quality Feedback form can help meet part of the EQUIP requirements.
Recently, the introductions of the new 2016 Digital Mammography Quality Control Manual and the new phantom are now available from ACR Accreditation. The digital manual is intended to guide the development and implementation of your quality control (QC) program for digital breast imaging equipment — including detailed responsibilities of the radiologist, technologist, and medical physicist. Facilities that use the manual can submit images obtained with the phantom, along with quality control results, to gain accreditation of their 2-D full-field digital mammography systems.
R-SCAN® in the News
Since its launch in 2015, the Radiology Support, Communication, and Alignment Network (R-SCAN®) has recruited thousands of radiologists and referring physicians. R-SCAN is a simple way to ensure that patients receive the most appropriate imaging based on a growing list of Choosing Wisely® topics. Additionally, radiologists and collaborating referring clinicians participating in the MIPS track of the QPP can earn seven medium-weight Improvement Activity credits for completing an R-SCAN project. The ACR also has launched a new CME activity under R-SCAN, developed specifically for referring clinicians. Gain experience with imaging clinical decision support (CDS) technology via the Imaging Order Simulation CME activity from R-SCAN. (Learn more at rscan.org.)
The R-SCAN program falls under CMS' Transforming Clinical Practice Initiative (TCPI). The program's goals include 1) achieving large-scale transformation, 2) improving outcomes, 3) preventing unnecessary hospitalization, 4) generating cost savings for payers, 5) preventing unnecessary testing and procedures, 6) paying for value, and 7) building the evidence base for scale and spread. TCPI offers a network with national reach across grant-funded Practice Transformation Networks and Strategic Alignment Networks (SANs) to help clinicians achieve large-scale transformation. The ACR is one of the 10 SAN grant awardees participating in TCPI. As a SAN, the ACR supports clinicians achieving TCPI goals through R-SCAN participation.
ACRedit Plus is a streamlined online platform designed to make the accreditation process more flexible and convenient than ever before. The new platform guides you through the accreditation process and delivers electronic final reports. Users can also calculate fees and deduct discounts automatically. The initial version of ACRedit Plus is now available for breast ultrasound and stereotactic breast biopsy.
By Dara L. Fox, editorial assistant, ACR Bulletin