Boston, July 2012
On behalf of the Massachusetts Radiological Society Officers and Executive Committee, I am pleased to share this update to help inform you about the most pressing issues facing our profession and our goals as a leadership team for the upcoming year.
It is an honor to serve as the President of the Society for the 2012-2013 term. I am incredibly grateful to have the support of a dedicated and talented team of volunteer leaders drawn from radiology, radiation oncology, and medical physics, supported by the guidance of our national leadership at the American College of Radiology, our legal counsel Mr. Ed Brennan, and our chapter administrator Ms. Ginny DuLong. In particular, I am indebted to our immediate past president, Dr. Christoph Wald, and am humbled to serve with such an accomplished group of officers: Drs. Phillip Devlin, Philip Rogoff, Alex Norbash, and Deborah Levine. We are also honored to serve you, our dedicated members, whose continued membership and support make it possible for us to pursue the missions of our society on behalf of our colleagues and patients.
• Multiple Procedure Payment Reduction (MPPR) & the 2013 Medicare Proposed Rule: As you are no doubt aware, Medicare imposed a new Multiple Procedure Payment Reduction (MPPR) on the professional component of imaging services in 2012, an egregious and ill-informed policy that seeks to subvert the well-established RBRVS valuation methodology in a manner that is inconsistent with real-world understanding of radiology and grossly overestimates the minor efficiencies associated with interpreting multiple studies on the same patient. Although the ACR was successful in reversing certain key provisions of the original CMS proposal through a grassroots effort last fall, the core MPPR provision as applied to individuals went into effect in January. The ACR continues to pursue a legislative fix to this issue through the Diagnostic Imaging Services Access Protection Act (separate House and Senate bills: HR. 3269 and S. 2347). The House bill in particular has gained considerable support, now with over 250 co-sponsors including 9 members of the MA Congressional delegation. Indeed, it was the efforts of the MRS and its members that recently earned co-sponsorship of Reps. Capuano and Olver after our Capitol Hill visits in April, and we are initiating a separate effort to convert the final member, Rep. Lynch (MA-9), this summer. However, the battlefield on this issue continues to shift, as CMS recently revealed its Proposed Rule for 2013 that again attempts to apply the MPPR not only to individual physicians, but across all members of a physician group. As a result, the MPPR discount would apply if another member of the same group reads the second or subsequent studies on the same patient on the same date, despite the clear lack of any efficiency in professional work when two different physicians interpret two different studies. The Proposed Rule also includes further expansion of MPPR into the technical component of cardiovascular services (including interventional radiology and nuclear medicine CPT codes) and cuts to the technical reimbursement of intensity-modulated radiation treatment (IMRT) and stereotactic body radiation treatment (SBRT) due to changes in practice expense calculations. Now more than ever, it is crucial for the ACR and the MRS to have support in this constant battle against unjustified payment policy.
• Massachusetts Healthcare Payment Reform: Recent MRS communications have detailed the ongoing discussions regarding Healthcare Payment Reform in the Commonwealth. The MRS has been an active participant in public and private discussions of the legislation, and we have been successful in certain key areas thanks to grassroots advocacy efforts with key leaders on Beacon Hill. While this represents a time of considerable uncertainty, we continue to advocate on certain key provisions on behalf of our members. We recently sent a letter to the members of the conference committee supporting draft language in the House version of the bill related to the implementation of appropriateness criteria and decision support. This letter also included a cautionary note on the use of indexes in the control of healthcare spending and support for MMS positions related to physician representation and registration of group practices. We will continue to monitor this legislation and work with colleagues from other medical societies, including the MMS, to attempt to influence the outcome at this crucial time.
•Managed Care: Under the leadership of Dr. Phil Rogoff and Dr. Art Waltman, the MRS continues to build close relationships with private and governmental payers. An ongoing effort, led by immediate past president, Dr. Christoph Wald, aims to create a partnership between MRS and Tufts Health Plan on issues related to radiation safety, with a focus on patient safety and scientific accuracy. We are hopeful that projects like these will continue to strengthen the ties between our society and the payers. An important advisory meeting with Tufts Health Plan will be scheduled for September, and we will be involving several local experts in these crucial payment policy discussions to help ensure a successful outcome.
Goals for the Coming Year:
• Advocacy: We have seen successful grassroots efforts at the national and state level this year, proving again and again the importance of involvement by a broad base of individuals who can get the attention of key leaders to help shape policy. The MRS will continue to advocate on behalf of its members on the key issues described above and we will continue to promote proactive discussions with regulators and elected officials to ensure that the MRS is involved in all key discussions, including those we cannot yet foresee.
We must continue to emphasize a core message: high quality radiology, radiation oncology, and medical physics are crucial to the delivery of modern healthcare and generate considerable value to the entire healthcare enterprise. Those who choose to focus solely on the costs of particular services fail to recognize the impact on overall quality, cost reduction, and improved outcomes that our involvement and expertise can deliver.
However, advocacy is a multifaceted activity that requires effort from each of us. This includes everything from formal meetings on Capitol Hill and Beacon Hill, informal gatherings or fundraisers, and letters and phone calls from direct constituents. To this end, we have formalized the creation of the MA Radiology Advocacy Network, which include two important parts: (1) a network of radiologists, radiation oncologists, and medical physicists throughout the state who can help share our messages and promote involvement in our “Calls to Action” and (2) closer ties to related organizations that can help promote issues of common interest, including the Massachusetts Society of Radiology Technologists (MSRT), Radiology Business Managers Association (RBMA), Association for Medical Imaging Management (AHRA), and local industry groups (including Philips). We will be working to develop our in-state member network this summer, and I am pleased to report that our related organizations have already agreed to help with future advocacy efforts. Finally, we continue to encourage participation of our members in advocacy events organized by the RADPAC (the ACR Federal PAC, which hosted an extremely successful effort for Senator Kerry last winter) and the MA PAC for Radiological Health (the MA state PAC). Please consider participating in these events in the future, as the small investment of time and money can pay considerable dividends in the future.
• Membership Growth: The MRS and ACR are dependent on members for support, leadership, and involvement, and in this time of considerable uncertainty, it is more crucial than ever that we involve all radiologists, radiation oncologists, and medical physicists in the state. I believe strongly that the ACR and MRS deliver incredible value for our members and that the small investment in membership dues is more than outweighed by the benefits of the many hard-fought victories won by the ACR and MRS in the past and the potential for future losses if our societies cannot devote sufficient resources on our behalf.
In this again, I ask for your help: please discuss the ACR and MRS with your colleagues and encourage them to join. Tell them about the importance of the ACR and MRS in providing leadership in issues of economics and government relations. If each member could recruit even just one more person into the ACR & MRS, we would be able to redouble our efforts on your behalf.
We will continue to share updates via email, and our website continues to be an excellent resource for members to learn more. Please share these excellent resources with your colleagues to help strengthen your case for involvement. The MRS is also on Twitter, a great way to get the latest updates. Just subscribe to @massradsociety for the latest.
I look forward to a productive year, and I thank you for your continued support. Please do not hesitate to reach out to me with any questions or concerns.
Sanjay K. Shetty, MD, MBA
President, Massachusetts Radiological Society