December Issue of the FRS & FRBMA
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FRS & FRBMA E Brief

  Greetings Ms. Roger,

 December 2015
Table Of Contents
Letter from the Editor | FRS President's Message | FRBMA President's Message
Legislative Update Become a PAC Member Today

Letter from the Editor
The 2015 Annual Meeting of the RSNA just concluded. From my vantage point, several interesting threads:

Workforce imbalance- the ACR Commission on Human Resources released its annual survey, reporting an estimated 1,131 to 1,484 job openings for radiologists in 2015. The job market appears to be modestly improving as compared to 2013 and is more closely approximating the number of radiologists completing their training this year (1,400). However, there is a potential troubling trend of increasing unfilled training slots in radiology residency programs. There is much more interesting data to be found in the report JACR November 2015 http://dx.doi.org/10.1016/j.jacr.2015.06.009

Embracing the changes occurring in radiology and its uncertainty as opportunity for some. The keynote address by Jeff Immelt, CEO for GE Healthcare, opined that progress in radiology is moving from the model of developing imaging equipment to growth by adding information and analytics to existing equipment. He described 3 themes for innovation in radiology going forward: precision medicine, the merger of radiology and pathology, and increasing mobility (both in the sense of developing mobile diagnostic devices as well as in image sharing over larger geographic areas). Darrell Kirsch, MD, the CEO of the Association of American Medical Colleges talked about how the cost-sensitive, population-based direction in which medicine is moving creates the need for increased alignment of doctors and hospitals. A concerning subtheme in his talk was the loss of traditional physician independence and leadership in the future delivery of healthcare, with a more collaborative, part-of –the-team role for future doctors. Not stuff that’s going to happen in the next few years necessarily, but food for thought in the intermediate to long term.

Emerging interoperability of imaging. Just like what happened in banking, the development of specifications, best practices, and policies to allow interoperability in imaging is underway. Only it took the financial services industry 20 years to accomplish it and the US government thinks healthcare is going to accomplish it in 3 years. The RSNA announced the launch of Image Share Validation Program which will certify vendor systems as compliant and interoperable in image sharing networks. GE unveiled its GE Health Cloud which will allow radiologists to share and study images as well as manipulates the data with new protocols. There were several works in progress talks regarding imaging sharing networks that are in various stages of early operation.

Scientifically, there were a significant number of sessions regarding imaging of traumatic brain injury and the emerging technology of PET/MRI. The overall feel of RSNA 2015 was less congested than in the past. Your smart phone is the new passport—Do "Case of the Day" electronically, use it to gain admittance to lectures, even watch a lecture remotely. Fewer lines, less likely to bump into an old acquaintance. Just like the practice of radiology, the new distributed, electronic world is changing the RSNA.

Steven DePrima, MD
Secretary, Florida Radiological Society
sjd_md@bellsouth.net

 

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FRS President's Message
December has arrived and soon many of our members will get a well-deserved break for the holidays. As we enter the New Year, FRS leadership will be very busy preparing for the challenges of the New Year, prepare for the annual meeting of the ACR and the summer annual meeting of the FRS/FRBMA in Amelia Island. The FRS board meeting will be held January 30th at ESI offices in Tampa, Florida. The meeting is open to any active board members. If you are interested, please contact Lorraine Roger at lroger@flrad.org. We welcome any of you that are interested in becoming more involved in the operations of the society or simply curious to the inner workings.

Each year the ACR Board of Chancellors awards the College's highest honor, the ACR Gold Medal to an individual for distinguished and extraordinary service to the American College of Radiology or to the discipline of radiology. It is a privilege to announce that one of our own and most distinguished members, Dr. Charles Williams has been selected to receive the Gold Medal Award in 2016. I hope you will join me in congratulating him as it is well deserved. Further information can be found on the ACR website at:
http://www.acr.org/Annual-Meeting/Program/Events/Awards-at-ACR-2016

In recent news, initial evaluations of the “Choosing Wisely” campaign are less than stellar (and perhaps no surprise). In a recent published analysis in JAMA (online publication 10/12/2015: http://archinte.jamanetwork.com/article.aspx?articleid=2457401), population-level analysis of seven recommendations changes were modest at best. Choosing Wisely was the creation of the American Board of Internal Medicine in April 2012 eventually using recommendations from over 70 medical organizations including ACR to develop evidence-based lists of tests and procedures considered overused and potentially harmful. Of the seven recently analyzed, four were imaging based. The percentage of imaging for headaches with uncomplicated conditions decreased from 14.9% to 13.4% (relative reduction of 10.1%) and the percentage of cardiac imaging in the absence of cardiac disease decreased from 10.8% to 9.7% (10.2% relative reduction).On the other hand, the percentage of preoperative chest x-rays in the absence of clinical suspicion of cardiothoracic disease went from 91.3% to 91.5% (relative change of 0.2%) and the percentage for low back pain imaging without red-flag conditions (a major contributor to health care expenditure) held stable at 53.7%. The authors concluded that additional interventions are necessary for wider implementation and acceptance including data feedback, physician communication training, systems interventions (i.e. clinical decision support in the EHR), clinician scorecards, patient-focused strategies and financial incentives. This is interesting as many of you are aware that CMS recently announced the delay in implementation of clinical decision support (CDS) systems for ordering advanced imaging studies originally slated for January 1, 2017. CMS now does not expect to have approved CDS mechanisms until at least summer of 2017. We will keep you posted on any further developments. Until then, happy holidays and I hope you will consider joining us at the board meeting in January.

Jeffrey Stone, MD, FACR
President, Florida Radiological Society
stone.jeffrey@mayo.edu

 

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FRBMA President's Message
As we near the close of the year, we business managers are all carefully monitoring and projecting our year-end financials. This has been an interesting year and full of challenges. I am hearing mixed reviews on the impact of ICD-10. Overall it has been relatively smooth, but there have been pockets of issues. A number of practice managers who I have talked with (within many different specialties) have indicated that the slower processing of payments in October have resulted in delays in collections at the end of October and the beginning of November. In our practice we experienced some delays, but they seem to have been corrected by the end of November. It appears that the one year “grace period” that CMS has instituted, has worked quite well. Let's hope that this continues into next year.

On another note, some good news is around the corner regarding the long awaited CMS payment instructions for low-dose computed tomography (LDCT) lung cancer screening. Medicare has announced that they will accept claims for these lung cancer screening studies retroactive to the date of the national coverage determination (NCD), which is February of 2015. They have announced a new G code for the low dose CT scan (LDCT) G0297. They also stated that they will deny claims if they do not contain the ICD-10 code that reflects a personal history of tobacco use and personal history of nicotine dependence. Many of us will be glad to receive payments for these patients we have treated.

If you haven't already made your reservations to attend the FRBMA Winter Retreat (January 28-29, 2016), I want to once again invite you to attend. We have a great line up of speakers and a number of opportunities to network with your colleagues around the State. This year we are once again at the Reunion Resort in Orlando. The program kicks off with a welcome reception on Thursday evening from 5pm to 7pm and concludes on Friday at 5pm. We had a great event last year and this year promises to be even better.

Finally, let me take this opportunity to wish each of you and your families the very best during this holiday season. See you in January!

Ed Goodemote PhD, RN
President, FRBMA
Chief Executive Officer
Radiology and Imaging Specialists
Lakeland, Florida
EGoodemote@risimaging.com
863-577-0303

 

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Legislative Update
This upcoming week of November 30th through December 4th is the last committee week before the sixty day session on January 12th.

The Governor will be presenting his budget before the House and Senate Appropriation committees.

During the last set of committee meetings, on Wednesday November 18th, CFO Atwater's consumer advocate Sha'Ron James made her presentation on the out-of-network "surprise billing issue" before the House Banking & Insurance committee. She would like to see legislation banning all balanced billing. She would also like to see a dispute resolution process put in place similar to Illinois.

Representative Trujillo refused the FMA's proposed solution to the ER balanced billing issue that was agreed upon by all the specialty society groups and we have yet to see his or the Consumer Advocates language. We hope to see the Consumer Advocates language this week and do not anticipate seeing Representative Trujillo's language in advance of when it is placed on the House B & I agenda soonest first week of Session.

It looks like Senator Rene Garcia will be filing the companion bill.

Please contact me at Alisondudley@dudleyandassociates.com, if you are interested in being involved in the balanced billing issue.

At this time the D.E.N.S.E. Breast bills have not been placed on any House or Senate calendars.

Thanks,
Alison
FRS Lobbyist
Florida Radiological Society
alisondudley@dudleyandassociates.com

 

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Become a PAC Member Today
Attention FRBMA Members! Please support the cause. We encourage you to be PAC members and supporters; you do not have to belong to the FRS. Donations can be made online through our PAC website www.FLRADPAC.org.

We would like to recognize the following contributors to the FRS PAC in November: Drs. M. Amendola, Assad, Entel, Foley, Harris, Katz, Mergo, Pevsner, Raskin.

It is critical that we support both our Florida PAC and RADPAC in order to bolster our voice in Tallahassee and Washington, respectively. Please join FRS lobbyist Alison Dudley in her special appeal for all Florida radiologists to become Florida PAC members. If you would like to help FRS defend radiology against untoward legislation and introduce bills that have a positive impact on our practices, we need your financial support to re-elect our friends in the state House and Senate. The FRS can also show you simplified ways on how to sign up your radiology group. Contact Lorraine Roger at lroger@flrad.org or contact Alison Dudley at alisondudley@dudleyandassociates.com for more information.

 

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