ACR Bulletin

Covering topics relevant to the practice of radiology

Focusing on Economics

ACR 2022 delved into hot topics such as the No Surprises Act, potential technical payment revisions, and radiology AI.
Jump to Article
June 24, 2022

Gregory N. Nicola, MD, FACR, chair of ACR Commission on Economics, moderated the ACR 2022 Economics Forum, which covered multiple topics, including the No Surprises Act, the Merit-Based Incentive Payment System (MIPS), the Contractor Advisory Committee (CAC) Network, potential technical payment revisions, and radiology AI.

Discussion of the disappointing interim final rule released by CMS to implement the No Surprises Act was especially timely. The final rule of the No Surprises Act has been used to empower insurers to drastically cut provider reimbursement, narrow medical networks, and restrict patient access to their chosen providers, including radiologists.

Richard E. Heller III, MD, MBA, spoke about the ACR and its “exceptionally proactive” work on this issue — including its joint lawsuit with the American College of Emergency Physicians and the American Society of Anesthesiologists to block implementation of parts of the surprise billing final rule regarding the independent dispute resolution process to determine fair payment for out-of-network emergency care.

Lauren P. Golding, MD, said that the ACR has been addressing MIPS by actively producing new measures specific to radiology that allow ACR members to continue successful reporting through the ACR Qualified Clinical Data Registry.

Sammy Chu, MD, FACR, briefed the audience on the ACR CAC Network. Chu noted that local coverage determination (LCD) policies are set by the Medicare Administrative Contractor. He added that members of the ACR CAC Network continue to play a critical role in the LCD development process and other proposed policy changes despite substantive changes to how the CAC operates.

Michael S. Booker, MD, and Joshua A. Hirsch, MD, tackled the difficult formulas that underlie physician practice expense, vital for calculating technical payments for imaging equipment and essential staff. Booker discussed the shortcomings of past calculations of indirect practice expense and stressed how future calculations will hinge on adequate and accurate data from practice leaders who understand the complex financial questions likely to be in a potential survey for future resetting of these expanses.

Kurt A. Schoppe, MD, and Andrew K. Moriarity, MD, addressed direct and indirect threats to radiology relative value units. Moriarity stressed that bundling of radiology services remains a significant threat, while Schoppe addressed how budget neutrality required in the Medicare Physician Fee
Schedule stymies innovation.

The forum wrapped with a discussion regarding AI and its use in radiology. Melissa M. Chen, MD, explained that there are currently two types of AI uses that get reimbursed — care coordination and democratization of care. Chen added that AI works best when directed by a radiologist. She said this beginning stage of AI use is an opportunity for radiologists to evolve as masters of these tools and that radiologists should incorporate those that allow them to provide the best possible patient care.