Your Board in Action
The BOC Fall Meeting brought radiology's most pressing issues to the forefront.
The ACR Board of Chancellors and Council Steering Committee (CSC) held their fall meeting Sept. 29–Oct. 4. The meeting focused on current initiatives with an eye to the future as the College seeks to respond to major challenges, including implementation of the Affordable Care Act, Medicare reimbursement and coverage decisions, and decision support initiatives — a key part of Imaging 3.0™.
In addition, the BOC reviewed financial and research reports, a self-evaluation of the board, an update on the CEO-search process, as well as presentations and reports on ongoing programs since May 2013.
Anne C. Roberts, MD, FACR, presented a review of the College’s finances, emphasizing that while the ACR is financially sound, changes and challenges within the profession and as a result of health care reform may have financial implications. The financial report included recommendations for a framework for approval of new initiatives by the Board of Chancellors, with a focus on tying resources to the strategic plan. Despite the financial challenges ahead, the board decided to keep dues rates unchanged for 2014.
Donald P. Rosen, MD, ACR chief research officer, reported on the College’s Research Advisory Committee and shared a potential research reorganization strategy, which included a detailed evaluation of existing programs, a proposed new structure, and elimination of programs not essential to the ACR mission. Updates were provided on ACRIN, the National Oncologic PET Registry, and RTOG. There was significant emphasis on the importance of clinical research and the reasons it should continue to be a pillar of the College.
The Canadian Association of Radiologists (CAR) has requested a change in representation from observer status to full ACR board status. CAR is concurrently considering restoring ACR representation on its board. The BOC will consider sponsoring a proposed bylaws amendment for restoration of the CAR board position in January.
The meeting focused on current initives with an eye to future as the College seeks to respond to major challenges.
During the meeting, the BOC also approved the recommendations of the Committee on Awards and Honors. Gold medals will be presented to N. Reed Dunnick, MD, FACR, of Ann Arbor, Mich., Carol M. Rumack, MD, FACR, of Aurora, Colo., and James H. Thrall, MD, FACR, of Boston. Honorary fellowship will be presented to Michel Claudon, MD, of France, and Gabriel P. Krestin, MD, PhD, of the Netherlands. The board also approved 109 new ACR Fellows. These awardees will be honored at the ACR Annual Meeting and Chapter Leadership Conference in April 2014.
Alexander M. Norbash, MD, FACR, discussed the newly formed ACR Head Injury Institute. His discussion focused on utilizing existing ACR assets, standardizing terminology, utilizing an information exchange, and facilitating clinical research to meet the goals of the new institute.
David C. Kushner, MD, FACR, chair of the Commission on Membership & Communications, reviewed the results of an external study on ACR membership. The commission’s newly formed think tank will review the recommendations and report back to the board at a future meeting.
Bibb Allen Jr., MD, FACR, chair of the Harvey L. Neiman Health Policy Institute board, provided a review of the Institute’s first year. Discussion included the Neiman Institute’s new app designed to assist radiology groups in preparing for new payment systems, establishing academic partnerships, and reviewing grant recipients. Richard Duszak Jr., MD, FACR, the institute’s chief medical officer, was congratulated on being selected as a finalist for Aunt Minnie’s “Most Influential Radiology Researcher” award.
Allen also provided an update on Imaging 3.0, an ACR-wide initiative launched at AMCLC 2013. The focus of his discussion included message delivery, the importance of decision support, and the culture shift and technology framework that will reposition radiologists across the patient-care continuum. Integration of IT and informatics tools to support data capture, management, and analysis were noted as essential components of Imaging 3.0’s efforts to demonstrate the value of radiology care to patient outcomes. Allen also reported on the components of the ACR’s Imaging 3.0 Care Network, the response to the CMMI Health Care Innovation Award, and the results of the Actionable Reporting Work Group, chaired by Paul A. Larson, MD, FACR. The work group has established 109 reportable findings in three categories, outlined in minutes, hours, and days. Next steps include reviewing the findings with all commissions and other radiology organizations.
James A. Brink, MD, FACR, chair of the Committee on International Education and Meeting, reported on the success of the first Global Summit on Radiological Quality and Safety (GSRQS). The GSRQS was sponsored by the ACR, the European Society of Radiology, and the International Society of Radiology to provide an international forum for the exchange of ideas and strategies and collaboration on worldwide quality and safety projects. The highly interactive three-day program will result in a published white paper. The next GSRQS is planned for spring 2015 in Europe.
Debra L. Monticciolo, MD, FACR, chair of the ACR Commission on Quality and Safety, reported on the development and progress of a lung cancer screening module within CT accreditation. Monticciolo requested an accelerated timeline for development of the module. Presentation and discussion of an accelerated guideline creation and an implementation process were reviewed by Kimberly E. Applegate, MD, MS, FACR, speaker of the CSC, in response to requests for a new lung cancer screening guideline. These initiatives come in response to the U.S. Preventive Service Task Force recommendation to reimburse for CT screening for high-risk lung cancer.
Cheri L. Canon, MD, FACR, chair of the Commission on Education, shared an updated program schedule for ACR 2015. Pathway co-chairs have been identified, and the committee has commenced marketing, is finalizing preliminary programs, has planned for increased registration, and has begun development of the ACR 2015 website.
Additionally, the board also heard brief updates from the 20 ACR commissions and reports from the CSC and its four work groups, the Radiology Advocacy Network, the Radiology Leadership Institute, the JACR®, and the Task Force on Interventional Radiology, and the 2013 ACR Forum.
Following a report by Katarzyna J. Macura, MD, PhD, chair of the ACR Commission for Women and Diversity, the BOC agreed to consider a study on women and general diversity in radiology.
The board also heard updates from the American College of Radiology Association (ACRA). Allen reviewed RADPAC® contributions to date, noting the importance of these special fundraising efforts. Of the more than 150 healthcare PACs, RADPAC continues to rank in the top five both in contributions raised and contributions made to members of Congress. RADPAC has already surpassed the $1 million mark in contributions raised in 2013, which makes this the fifth straight year of achieving this milestone.
Geraldine B. McGinty, MD, MBA, FACR, chair of the Commission on Economics, provided an economics update on critical issues, including the proposed CMS rules for 2014. McGinty pointed out the specialty estimated impact in the Medicare Physician Fee Schedule for radiology (-1 percent), radiation oncology (-5 percent), nuclear medicine (1 percent), and interventional radiology (-4 percent), not considering the yearly physician update (i.e., the conversion factor). McGinty noted that breast biopsy codes, including new bundled codes, will be in place starting in January 2014, with significant reductions likely. McGinty also discussed the economics of Imaging 3.0 and provided an update on new payment models in breast imaging, lung cancer screening, and stroke imaging.
Cindy Moran, assistant executive director of government relations, economics, and health policy, provided a legislative update reporting on the failure of Congress to agree on a budget, subsequent government closures, and the battle over the debt ceiling. She also discussed progress on the Medicare Patient Access and Quality Improvement Act of 2013, which would eliminate the sustainable growth rate and block the 25 percent professional component reduction from the multiple procedure payment reduction. She highlighted two new ACR communications and two online publications: the “Advocacy in Action” e-newsletter (www.acr.org/Advocacy/eNews), and “The Voice of Radiology” blog (http://voiceofradiologyblog.org), both of which will keep members apprised of federal legislative and regulatory issues on a weekly basis. Advocacy and economics issues will be featured in live webinars, in monthly video podcasts, and through the use of social media.
By Paul H. Ellenbogen, MD, FACR, Chair