Meet the ACR Leadership: Geraldine McGinty, MD, MBA, FACRMeet the ACR Leadership

This is an installment of a series titled “Meet the ACR Leadership.” Throughout the series, we interview the ACR Leadership to get insight into their background and involvement in the ACR. For this installment, we talk with Geraldine B. McGinty, MD, MBA, FACR, Vice Chair of the ACR Board of Chancellors (BOC). She was previous Chair of the Commission on Economics and assistant professor of radiology at Weill Cornell Medicine.

You have been involved in many facets of the ACR. How did you get involved in the ACR and what has kept you involved?

I started working in the Bronx at Montefiore shortly after completing my training and was charged with starting an outpatient imaging center there. I did that for a couple of years and as it grew, I then realized that I needed more formal business skills. I was very fortunate to go to business school and get my MBA. My department chair, who was chairman of the Board of Chancellors at that time, told me it was time to give back to the field and volunteer with the college. I was delighted to comply and joined the “farm team” started by William T. Thorwarth, MD, FACR, who was then Chair of the ACR’s Commission on Economics.

I’m driven especially because I’ve worked so extensively in economics and payment policy. We provide invaluable services to our patients, so we have to make sure our services are performed with verified quality and that those services are appropriately reimbursed. I truly believe you can shape patient care with payment policy. I have been really passionate about making sure that we do have the policy that shapes high value.

For example, if lung cancer screening was not covered by Medicare then the number of people who would access it would be low. If mammography was not covered every year by insurance, not as many patients would have mammograms. We know both of those tests save lives. It is important that we advocate for payment also at an adequate level so people invest in the best technology, hire the best technologists, and maintain their skills. All of those things contribute to the very best level of quality.

What is the ACR BOC and what is your role as Vice Chair?

The BOC is the executive body of the ACR responsible for making sure the policies and programs which the ACR Council has adopted are implemented. I think I was selected because my deep knowledge of health care payment policy is helpful at a time when the payment system is radically changing; this includes the MACRA (Medicare Access and CHIP Reauthorization Act) legislation that will restructure Medicare payments.

My role is to support our Chair, James A. Brink, MD, FACR, and make sure his priorities are appropriately executed. In my two-year period as Vice Chair, I plan to learn more about the breadth of the ACR’s programs, especially areas such as the Research and Quality and Safety programs that I’ve not been as familiar with.

You were the Chair of the Commission on Economics. What is role of this commission and what was your experience like?

The Economics Commission is the ACR’s voice for all things related to health care payment policy. It interacts with government payers like Medicare/Medicaid and commercial payers. There are multiple committees under the Commission’s umbrella: some of these subcommittees focus on subspecialties such as neuroradiology and breast imaging, and others subcommittees relate to different types of practices, such as rural practices. The Commission on Economics is the body of the ACR that responds to Medicare’s yearly changes in payment, as well as policies issued by commercial payers and Medicaid programs. The volume of work is significant.

My time as chair of the Economics Commission was incredibly satisfying because I had the ability to work with a phenomenal staff and group of more than 300 volunteers. The physician volunteers who work on the Commission spend countless hours of their free time pouring through payment edits that Medicare sends out or developing comments on policies. I learned so much from working with these incredibly smart people. My role was making sure we were adequately represented in all the different areas and advocating for appropriate resources from the College. The ACR takes its economics mission very seriously and members value this as an important benefit.

Were there any special projects that you had while on the Commission of Economics?

One of the things I did during my term, which was a lot of fun, was collaborate with the Resident Fellow Section to start a monthly online journal club targeted to residents who were interested in economics. What we wanted to do was help the trainees learn about health care payment policy specific to imaging and get them to connect with experts in the economics area. We usually picked a couple of articles and had a guest panelist followed by a discussion. Past guest hosts have included economics leaders in the College such as Richard Duszak Jr., MD, FACR as well as external experts such as David Lee, chief economist at General Electric.

Almost 5 years later, the Journal Club is still going strong and I’d encourage residents to check it out. You can find details on the RFS page of the ACR website.

What can you tell us about your extensive work on the Imaging 3.0® initiative?

That initiative was launched by Bibb Allen, Jr., MD, FACR, our current ACR president, when he was Vice Chair of the Board of Chancellors. We were hearing a lot about the transition of healthcare from volume to value. We thought that radiologists provided a lot of value but weren’t necessarily recognized for it. Because of all the technological advances like PACS, we had become somewhat invisible and weren’t as much a part of the health care value conversation as we needed to be. This was a project around demonstrating our value, connecting more effectively with our referring physicians and our patients, and then shaping payment policy to incentivize high quality radiology and radiologist communication with the healthcare community. Although there has been a profound culture change in the specialty, this is still an ongoing process. We developed a lot of great tools to demonstrate and measure the quality that we deliver.

In terms of incentives and shaping policy, the new MACRA legislation is starting to recognize this, but that legislation is complex and needs to be shaped and formed over the next few years to make sure that radiologists are appropriately recognized for their integral role in delivering high value care.

What advice do you have for residents and fellows interested in pursuing a future in ACR leadership?

Get involved. Stay involved.

Don’t be disheartened if the first thing you get involved with is not necessarily what really fits you. I started doing work in quality and safety; while it was incredibly important work, it wasn’t necessarily my passion which I found in economics. Be open to whatever is in front of you and if you’re given an opportunity, work hard.

The other thing I’d say to residents is that when they first get involved, it may sometimes feel a little uncomfortable to ask questions. You feel like everybody else knows what’s going on except you. The ACR staff is endlessly patient and incredibly knowledgeable. They’re happy to help you understand the concepts and give reading material. Don’t feel overwhelmed, especially in economics. Don’t expect to know it all at once and understand there’s a learning curve.

My work with the ACR has been one of the most satisfying experiences in my professional career. Not just because of the work which I think is really important but because of the people I’ve gotten to work with and meet. That includes everyone from residents up to former board chairs. I really encourage people to get involved.

By Victor Fong, MD resident at Eastern Virginia Medical School.

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