Future by Design
Imaging 3.0™ and the future of the profession dominate the economics session of AMCLC.
As part of Tuesday's AMCLC programming, ACR leadership presented the economics program and armed members with the tools to thrive in the changing health care environment.
Tuesday morning, AMCLC participants learned about the efforts of the College's economics team. Led by Geraldine B. McGinty, MD, MBA, FACR, chair of the Commission on Economics, the session focused on one of the main tenets of Imaging 3.0™: demonstrating the value of radiology to all stakeholders, from patients to payers. Such topics as the team's efforts within the Relative Value Scale Update Committee (RUC) and Hospital Outpatient Prospective Payment System (HOPPS), as well as with CMS and other payers were discussed within the Imaging 3.0 framework.
Leah Binder, president and CEO of the employer-focused Leapfrog Group, offered a session highlight representing a perspective beyond radiology. Binder described the seismic changes taking place in the health system, including consumerism and patient awareness of quality and price of care. She emphasized the need for radiologists to embrace the principles and tools offered under the ACR's Imaging 3.0 initiative and to show measurable gains in system improvement. "Imaging 3.0 is one of the most exciting things I've seen from any specialty," she noted.
According to Binder, health economists believe the influence of high-deductible health plans has already contributed to a reduction in national health spending and that consumers' out-of-pocket spending tops that of employer-funded or government programs. She also noted that consumers now expect physicians to be more transparent in demonstrating quality and value. "If you stay true to transparency, you will get ahead," she said.
Ezequiel Silva III, MD, FACR, ACR's adviser to the RUC and vice-chair of the Commission on Economics, discussed the apparent schizophrenia of support fee-for-service (FFS) payment structures like the RUC while driving toward a value-based payment system. Currently, he said, radiologists occupy an awkward middle ground and should not believe that FFS is dead. In fact, Silva outlined five reasons FFS should still be defended:
1. FFS will not disappear anytime soon, if ever.
2. Every alternative payment model involves FFS at some level.
3. Current pay-for-performance initiatives are driven by FFS.
4. Most productivity metrics are still tied to RVUs at some level.
5. We need to be engaged (and credible) now to remain so in the future.
Silva also noted how well-respected the ACR is on the RUC. The Department of Health and Human Services "knows who we are," Silva stated, and recognizes the College as a credible source of information.
Raymond K. Tu, MD, FACR, Christopher G. Ullrich, MD, FACR, Daniel Picus, MD, FACR, RCC, James V. Rawson, MD, FACR, Mark O. Bernardy, MD, FACR, and Robert K. Zeman, MD, FACR, rounded out the session with coverage of local and national payment structures and clincial decision support, including ACR Select™.