Bringing Together Radiology Health Policy and Economics

From the Chair of the Commission on Economics

 

Gregory N. Nicola, MD, FACR

The ACR Commission on Economics is multifaceted. I want to use this month’s column to highlight a little-known group within the commission that is doing important work for the College — the Future Trends Committee (FTC). The late David C. Levin, MD, FACR, professor and chair emeritus of the department of radiology at Thomas Jefferson University, and other ACR luminaries recognized an opportunity to periodically bring together radiology health policy, economics and other thought leaders to take advantage of their collective wisdom. The charge of this auspicious group both was and is to consider issues that could potentially impact the economics of radiology in the future — hence, the name. Howard B. Fleishon, MD, MMM, FACR, was serving as FTC chair when this role was challenged by his emerging leadership on the ACR BOC. At that time, Joshua A. Hirsch, MD, FACR, was asked to lead the FTC, and he continues to serve as chair today. Working with Katie Keysor, ACR senior director of economic policy, and Christina Berry, ACR team lead on economic policy, the committee has grown to include more frequent meetings, a summer session, diversified membership and reports to ACR Commission on Economics leadership.

As chair of the ACR Commission on Economics, I am a de facto member of the FTC. In this month’s column, I will share four examples from the last two years of topics that were discussed by the FTC.

1. Meeting With ACR Government Relations
   Every other January (the ones that follow an election year), the FTC hosts a meeting with ACR’s Government Relations staff. This year Josh Cooper, vice president of government relations and economics health policy, and Rebecca Spangler, ACR senior government relations director, provided an overview of the 2024 election results and what those results may mean for healthcare laws and regulations. The discussion included the much-needed Medicare Physician Fee Schedule Conversion Factor fix for 2025 that has yet to happen. They also discussed potential long-term Medicare payment reform, the new administration and Congress’ views on artificial intelligence and what potential changes ACR is monitoring. The discussion was, as always, held in a nonpartisan manner focused solely on issues that impact radiologists and their patients.
2. Overview of Medicare Advantage
   Recognizing that more than half of all Medicare beneficiaries are now choosing to enroll in Medicare Advantage plans, the FTC hosted a RBMA member in March who presented an overview of how Medicare Advantage works and how its increasing popularity may impact radiology. Private payers advertise great benefits to patients above and beyond traditional Medicare. Because Medicare Advantage plans are paid a per-beneficiary rate, there is strong incentive for payers to control utilization and push for low contract rates for providers, particularly non–patient-facing specialties like radiology. The FTC had a robust discussion on what radiologists can do to improve the issues within Medicare Advantage. This is a topic that the ACR Payer Relations Committee will be focusing on this year.
3. Considering Climate Change
   In spring 2024, the FTC was joined by Reed A. Omary, MD, MS, who provided the committee with steps to address climate change within radiology and medicine. Omary also explained how taking ownership of climate-change challenges within medicine may drive the next generation of radiologists. The session provided an interesting look at how an issue as large as climate change can be directly impacted by radiology practice.
4. Impact of High-Cost Equipment Reimbursement
   In June 2024, Gerald A. Niedzwiecki, MD, an interventional radiologist, provided a unique perspective on high-cost equipment reimbursement in an office setting. This discussion centered around how the impact of high-cost equipment reimbursement has transformed the practice of radiology by decreasing the financial feasibility of certain in-office procedures. The conversation highlighted how the many issues facing radiology practices all relate to each other.

The ACR Commission on Economics works in constant service to radiology. I’m pleased to share this behind-the-scenes look at how one of our key committees is serving College members year-round. The FTC is an essential group challenging the Commission on Economics to consider issues that could potentially affect the economics of radiology in the future. I am always impressed by the enthusiasm and knowledge this committee brings to any topic being discussed. Any committee is only as good as its chair, staff and members. In this case, the committee chair happens to be one of the most effective and capable leaders I have met in my career. I would like to extend my deepest gratitude to Dr. Joshua Hirsch, the FTC Committee members and ACR staff.