Geraldine McGinty, MD, MBA, FACR, gave radiologists and imaging administrators a glimpse of her world view as chair of the American College of Radiology Board of Chancellors during a January 12 lecture at the 2019 ACR/RBMA Practice Leaders Forum.
It is a perspective framed by the governing aspiration that ACR members and the radiology community as a whole should be universally acknowledged as leaders in the delivery and advancement of quality health care, she said. And, it has led McGinty to adopt specific priorities to guide her two-year term as board chair.
Three such priorities revolve around ACR core practices relating to the federal government’s evolution from fee-for-service reimbursement to a hybrid system that also rewards clinicians for the value of their care and their optional participation in alternative payment models. Ensuring radiology’s value under existing fee-for-service and alternative payment models is a priority, according to McGinty, as is the importance of playing a leadership role in the collaborative development of new payment models. Education is a priority as well to train ACR practice leaders, members and members-in-training about the full spectrum of payment models and how to succeed under these models.
Radiology leaders must be aware of the evolution of programs enacted through both the Accountable Care Act (ACA) and MACRA, she said. ACA’s promotion of accountable care organizations led some health systems to merge and accelerated the purchases of radiologist and other specialty physician practices. The consolidation of radiology practices, including acquisitions funded with investments from private equity firms, is also a dynamic and disruptive trend. The regulatory burdens associated with the ACA and MACRA have been cited as a contributing factor in this development, she said.
Cultivating external relationships and membership engagement are important priorities for the ACR. Under Dr. McGinty’s leadership discussions are ongoing with the College of American Pathologists to explore areas of common interest, including driving the safe and effective incorporation of artificial intelligence (AI) tools.
Member engagement involves ensuring that the ACR meets its members’ needs and fosters a welcoming community for radiologists. Diversity and inclusion, wellness and leadership development are all goals that the ACR has established.
Among the programs McGinty highlighted as supporting these goals are the Engage platform to foster communication among ACR members, the Commission for Women and General Diversity, the PIER scholarship program to draw underrepresented minorities into radiology, and affinity groups, such as the Senior and/or Retired Section.
Engagement is also relevant to Patient- and Family-Centered Care (PFCC), another McGinty priority. She pointed to the College’s PFFC Toolkit, which provides support to practices looking to refocus on a more patient-centered workflow. She mentioned the patient-friendly summaries of the ACR’s Appropriate Use Criteria, which are a new effort from the Journal of the American College of Radiology to ensure that patients understand the value of appropriate imaging. And, she challenged the attendees at the Practice Leaders Forum to think about how the radiology profession can move the needle on participation in lung cancer screening, which has reached only two percent of eligible patients.
McGinty also stressed the importance of the ACR’s research activities, such as its administration of the National Lung Screening Trial in directly influencing innovations in practice. Research conducted by the Neiman Health Policy Institute has impacted practicing physicians by documenting the lack of evidence for policies, such as the multiple procedure payment reduction. The institute’s inquiry led Medicare to roll back the policy to return reimbursement rates for high-tech medical imaging to more appropriate levels.
Despite the use of AI in health care being the subject of considerable hype, there is real substance that can usefully drive better patient care and outcomes if harnessed appropriately, McGinty said. In discussing the work of the ACR’s Data Science Institute, she reinforced the need for a strong ecosystem that brings together physicians, developers and industry while putting the patient’s needs first.
As for long-term prospects radiology for medical students considering it as a career, McGinty ended on an optimistic note. “If you want to be in the specialty that’s going to most effectively harness AI for the benefit of patients, that’s going to be radiology,” she said.