Taking Stock

With new payment models throwing health care into transition, now is the time to remember why we became physicians in the first place.


August 2015

It’s August and I hope that you all are enjoying at least a little downtime this summer. Even my hectic adopted city of New York is quieter these days, and it’s a good time to recharge the batteries.

That said, the career we have chosen means that the needs of our patients always comes first, so many of you are probably working harder than ever, especially if you’re generously covering for colleagues on vacation.

One of the biggest challenges for the Imaging 3.0™ initiative is convincing busy radiologists who’ve seen their reimbursements cut that there is value in connecting with referring colleagues and patients before the payment system adequately recognizes those activities. When I speak at national meetings and to individual practices, I’m often asked how to carve out the time when the worklist still needs to be cleared by the end of the day.

One solution is to make sure the practice is staffed to support those activities. The easing up of what was, for the last couple of years, a very lean job market for our graduates suggests that many practices are adopting that approach. Another approach involves a bit more of a leap of faith but I guarantee it will reap rapid rewards.

The notion that we can energize our interpretive practice through strengthening our connections with our colleagues and our patients might seem fuzzy to some. Stay with me on this though.
I’m a practical person. Much of my work for the College involves concrete concepts like RVUs, dry legislative language, and time spent ensuring that deadlines are met. My main clinical focus is mammography, which can seem repetitive (especially for screening purposes) with really only one disease entity to consider and technology that can be as frustrating as it is illuminating. But in both of these arenas I am sustained and inspired by the patients I meet and the colleagues with whom I collaborate. Take the couple that came in to hear the wife’s results this week, for example. Married 45 years that day, the husband clutching his wife’s purse and the wife as white as a sheet. I told them that her mammogram was in fact normal and we could see her next year. I watched them visibly relax, hug each other and then me. This is why we do this, isn’t it? A couple of those encounters each day on clinical service keep me going and remind me of how much I love being a doctor and a radiologist.

I wouldn’t be fulfilling my role as chair of the Commission on Economics though if I didn’t work to make sure that eventually the health care payment system not only recognizes the value-added activities we provide but also appropriately incentivizes them. We are practicing in a time of great opportunity, and the ACR is engaging our entire community to make sure that the value-based activities for which we advocate for payment are relevant and meaningful. As you’ll have read, the repeal of the flawed SGR payment formula has resulted in a new roadmap toward value-based payments for Medicare and probable closer coordination between Medicare and commercial payers on metrics and incentives.

Many of you will have completed our survey on the types of value-based payment models and metrics that you’re already experiencing, and we thank you for your participation in this important project. When, in 2022, 9 percent of your Medicare payments are based on participation in a value-based payment model, my aim is that you will be participating in a way that not only delivers the highest-quality care to your patients but also improves your practice and professional satisfaction. These are lofty goals indeed when so many of the existing programs, like PQRS, can be frustrating. But we’ve been specifically invited to be part of developing these new payment models, and I am determined to give it our very best effort.

So whether you are reading this on the beach or sweating your way through your workday, I hope you are heartened by the thought that the work we do immeasurably improves the lives of our patients and our communities and that we have the opportunity to align our health care delivery and payment system with the goal of driving even higher quality and value.

McGintyHeadshotBy Geraldine B. McGinty, MD, MBA, FACR, Chair

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