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Mammography rates increased after the Affordable Care Act (ACA) eliminated cost sharing for preventive services recommended by the U.S. Preventive Services Task Force, according to a new study published by the New England Journal of Medicine.

One of healthcare’s most common debates is which of the many different breast cancer screening guidelines women should follow to receive the best possible care. The authors of a new study in the American Journal of Roentgenology ran a Monte Carlo computer simulation to put the screening mammography guidelines released by the American Cancer Society (ACS) in 2015 up against the updated recommendations released by the U.S. Preventive Services Task Force (USPSTF) in 2016.

Radiation oncologists should be more directly involved in the formal education of medical students, according to a new study published in the Journal of the American College of Radiology.

New research published in Current Problems in Diagnostic Radiology suggests procedural training should be standardized during residency and competence in specific procedures should be achieved at its completion.

The Merit-Based Incentive Payment System (MIPS), developed by CMS to pay physicians under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, is one of many things today’s imaging leaders must understand to help their groups stay ahead. According to a recent study in the Journal of the American College of Radiology, CMS exempts certain physicians from participating in MIPS, but many radiologists will find they must participate.

 

Recent Headlines

Physicians Are Leery of Exchange Participation

Some observers have commented on the narrow networks associated with many insurance products being offered by the state and federal insurance exchanges mandated by the Patient Protection and Affordable Care Act (PPACA). A new survey¹ of members of the Medical Group Management Association (MGMA) suggests why insurers may be having trouble attracting broader physician panels. The MGMA received more than 1,000 responses from practices representing more than 47,500 physicians.

A Yawning Void

As Ezequiel Silva III, MD, makes perfectly clear in his guest editorial in this issue, the entire continuum of radiology delivery services is inches away from getting slammed—again. The root of radiology’s latest problem is in a 2007 report¹ (based on data of an even earlier vintage) from RTI International, LLC, that recommends separate cost centers for MRI and CT.

The In-office Ancillary-services Exception: Time to Ground the Skyrocket?

Some battles are destined to be fought over and over again. The fight to eliminate the IOASE is one such skirmish; it refuses to go away, after more than a decade of debate.

Washington 2013: Imaging at the Grindhouse

Imaging has been through a long legislative and regulatory grind since the first big blow was struck with the DRA, and there is little to indicate that much will change on that front in 2013, according to Ted Burnes, MPA, director of RADPAC, the political-action committee of the ACR®. With Maurine Dennis, MPH, MBA, a consultant for the RBMA, Burnes copresented “Radiology Economics and RADPAC Update” on May 22, 2013, at the RBMA Radiology Summit in Colorado Springs, Colorado.

The MAC–CMS Disconnect

As we previously reported,¹ last fall, CMS published its supposedly final guidance² on place-of-service requirements for the professional and technical components of diagnostic tests. Transmittal 2563 (later replaced by Transmittals 2613 and 2679) revised the instructions contained in chapter 13 of the CMS manual system for Medicare claims processing. The most recent transmittal became effective on April 1, 2013. On April 25, CMS issued a frequently asked question (FAQ)3 set to respond to additional concerns about the place-of-service instructions. Among other clarifications in the FAQ list, CMS reported that it will be developing a national enrollment policy for telehealth and telemedicine services.

Anatomy of a Pay Cut My initial reaction was to flinch and move on, like a punch-drunk fighter, when I heard about the 90% assumed equipment-utilization rate in the omnibus bill intended to avert the fiscal cliff. Instead, I bear witness to the latest in a series of cuts to the technical and professional components of radiology reimbursement.
Navigating the Regulatory Landscape: The 8 Top Legal Issues of 2012 Idle hands are said to be the devil’s workshop; in 2012, government regulators proved the same to be true of hands that are busy, as evidenced by the new and modified rules that they churned out to address perceived problems in the delivery of radiology services. Many of these rules—brought forth by DHHS agencies—were unhelpful to radiology practices striving to keep their heads above water. In fairness, though, one or two rules were of the opposite character.
Putting Lung-cancer Screening Through the Actuarial Wringer

An article by Milliman actuaries¹ in the April 2012 issue of Health Affairs details an interesting accounting exercise that is likely to cause private insurers to take notice. Using a method employed to evaluate new insurance features, the researchers created an actuarial model designed to estimate the cost (and cost benefit) of lung-cancer

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