ACR Bulletin

Covering topics relevant to the practice of radiology

Delving Into Radiologist Payment Policies

The ACR 2019 Economics Forum focused on MACRA, CPT® code valuation, Medicaid payments, and other topics.
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Radiology is well-positioned to contribute to discussions occurring at the AMA across a range of common issues.

—Ezequiel Silva III, MD, FACR
June 25, 2019

ACR 2019 included a half-day Economics Forum, organized by the ACR Commission on Economics. I wish to thank the faculty who contributed, as well as the audience who made the session interactive and thought-provoking. Here are the three themes that emerged from this year’s forum:


In my May Bulletin column, I described the importance of building a strong infrastructure to respond to political change. This premise is equally important within the context of innovation and technological change. As our forum showed, the Commission on Economics has expertise across the spectrum of radiology payment policy — including Current Procedural Terminology, AMA/Specialty Society Relative Value Update Committee valuation, coverage determination, hospital payment, Medicaid services, private payors relations, and new payment model development. Across these domains, the ACR has a rich history of bringing innovative radiological technologies to patient care, and these technologies are emerging and evolving in ways we may not have predicted even a few years ago. The statutory, regulatory, and payment policy surrounding AI continues to evolve quickly, and the ACR infrastructure positions us to inform those directions. Obviously, the ACR Data Science InstituteTM will be an important partner — as will the Commissions on Quality and Safety and Patient- and Family-Centered Care, among others.

Radiology is well-positioned to contribute to discussions occurring at the AMA across a range of common issues.

—Ezequiel Silva III, MD, FACR, Chair

External Relationships

The internal ACR partnerships I describe are hugely relevant. Just as relevant are the relationships across the house of radiology. In fact, ACR BOC Chair Geraldine B. McGinty, MD, MBA, FACR, has made external relationships a focus of the remainder of her tenure. Our Economics Forum and its diverse set of faculty highlighted this point. We had presenters who are leaders in other radiology sub-specialty societies, such as the American Society for Radiation Oncology, the Society of Interventional Radiology, the American Roentgen Ray Society, and the American Society of Neuroradiology.

Relationships across the house of medicine are also key, and the AMA and our state medical societies are key partners. Radiology is well-positioned to contribute to discussions occurring at the AMA across a range of common issues. Examples include surprise billing, scope of practice, prior authorization, and the regulatory landscape surrounding digital technologies, including AI. In fact, I believe there should be a radiologist on every state medical society delegation to the AMA, so those voices are more effectively heard.

Contemplating Both Sides

The second part involved a debate format during which two experts presented counter-arguments on the topic at hand. More importantly, the viewpoints expressed by those individuals may or may not have been congruent with their personal and professional beliefs and actions. In other words, the academic exercise forced those presenters (and the audience) to consider alternative views. This highlights the importance of hearing, understanding, and even taking both sides of an argument. Understanding one’s own position is strengthened by acknowledging and seeking to understand the opposite point of view.

After our debates, we polled the audience, via applause, on which of the two arguments was the more compelling. The responses to this informal poll were interesting and sometimes surprising, but certainly informative. Collecting the opinions of the members is at the heart of any membership society, thus informing the actions of that organization.

Once again, I’d like to extend gratitude to all who contributed to our session. I hope it was evident that the College and the Commission on Economics are continuing our commitment to advancing our profession through meaningful and far-reaching contributions.

Author Ezequiel Silva III, MD, FACR  Chair, ACR Commission on Economics