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 Quarterly
Update
Maryland
Radiological
Society
Spring 2013
Fall 2012
Resident & Fellow Section
From the President
It is my privilege to serve as the President
of the Maryland Radiological Society and
I would like to take this opportunity to
thank Past President Albert L. Blumberg,
MD, FACR for his over 20 years of service to
the MRS and his long-term engagement
in the legislative efforts directed towards
preservation of Maryland’s self-referral
law banning non-radiologist involvement
for financial gain with CT, MR and
radiation oncology services. Dr. Blumberg
was elected President of the ACR during
the recent 90th Annual Meeting and
Chapter Leadership Conference (AMCLC)
in Washington, DC, and we are looking
forward to his continuing leadership.
The MRS had a strong presence
during the 2013 AMCLC and was well
represented during our lobbying visit
to the Capitol Hill. The most important
continued on page 2
Maryland
ACR
Annual
ACOs & Bundled
Radiological
Meeting
Payments
Highlights Society
Katarzyna J. Macura, M.D., Ph.D
President, MRS
The Executive Board of the Maryland
Radiological Society approved the creation
of the Resident Fellow Section (RFS) for the
Maryland Radiological Society during its
meeting on June 18, 2013.
The RFS purpose will be:
1. To provide a unified voice for radiology
residents in Maryland
2. To promote the interchange of
information and opinion between
resident physicians and fellows in
training programs in Diagnostic
Radiology, Radiation Oncology, and their
subspecialties throughout the State of
Maryland
3. To assist in maintaining consistency
in standards for radiological residency
and fellowship training programs
throughout the State of Maryland as set
by various regulatory organizations;
4. To provide a forum for the education of
residents and fellows in the ethical and
socioeconomic aspects of the practice of
radiology
5. To provide a mechanism for input and
involvement by residents and fellows
in the educational, socioeconomic,
and policy-making functions of the
Radiological Society of Maryland.
MRS Spring Meeting Report
Gene Ransom
Daniel Seeburg, MD, PhD
CEO, MedChi
Presented on May 21, 2013
Attending the resident and fellow section
(RFS) of the ACR AMCLC in Washington,
D.C. was an eye-opening experience.
As a second year radiology resident at
Hopkins, I hadn’t heard much about the
ACR, and was eager to learn more about it.
We spent the first two days with hundreds
of other first time and returning residents
and fellows, who had traveled to D.C.
At the spring general meeting for the
Maryland Radiological Society Gene
Ransom, MedChi CEO examined the
structure and operations of Accountable
Care Organizations (ACOs). Ransom
discussed current and future ACOs in
Maryland and examined how ACOs will
affect radiology practice and patients.
continued on page 3
continued on page 4
Fall 2012
Gene Ransom (left) and
Albert Blumberg, MD, FACR (right)
MRS Quarterly Update Spring 2013 Page 2
From the President
Katarzyna J. Macura, M.D., Ph.D
continued from page 1
issues that we discussed with legislators
were: 1) opposition to the Multiple
Procedure Payment Reduction (MPPR)
to the Professional Component (PC)
of diagnostic imaging services urging
Representatives and Senators to
cosponsor H.R. 846/S.623 (the Diagnostic
Imaging Access Protection Act) which
blocks further implementation of the PC
MPPR; 2) enacting meaningful imaging
utilization management policies that will
apply computerized decision support
(CDS) tools to reduce the number of
incorrect or inappropriate exams, focus
on education of ordering physicians
as to what imaging tests are the most
appropriate for their patients, and provide
meaningful data to better determine the
best use of imaging resources in the future.
We visited offices of Representatives
Andrew Harris, Christopher Van Hollen,
Charles Albert “Dutch” Ruppersberger
III, John Sarbanes, and John Delaney, as
well as Senators Barbara Mikulski and
Benjamin Cardin.
very refreshing to see
radiologists in training
so
enthusiastically
engaging
in
the
advocacy efforts on
behalf of our specialty.
With impending
changes to the health
care delivery and
reimbursements, the
radiology community
must critically reevaluate the role of
radiologists in health
care and develop new Passing of the President’s Gavel:Past and Current MRS Presidents
processes for improved
Albert Blumberg, MD, FACR and Katarzyna J. Macura, MD, PhD
engagement
with
referring
physicians
and patients in a patient-centered service and behavioral changes of radiologists
model with continuous improvement will need to be implemented to optimize
of quality and safety of imaging care. To high-value imaging care in the future
that end, the ACR developed an initiative health care delivery systems. I encourage
called Imaging 3.0 that describes the new you to learn more about this initiative
direction for the radiology practice in on the ACR website as Imaging 3.0 is a
which our services will be delivered with call to action to all radiologists to take
applying principles of appropriateness, a leadership role in shaping America’s
quality, safety, and efficiency while future health care system:
shifting from the current paradigm
focused on volume to the future valueht t p : / / w w w. a c r. o rg / Ad vo c a c y /
based radiology. A set of tools enabled Economics-Health-Policy/Imaging-3
by advances in informatics, i.e. CDS tools,
Maryland
Radiological
Society
We were fortunate to have 5
residents join us during the Capitol Hill
visit, and they share their experience in
a separate note in this newsletter. It is
Fall 2012
MRS Meeting with Senator Ben Cardin
Back Row: Anand Narayan, Chris Trimble, Arvind Sivakumaran, Robert Paley
Front Row: Katarzyna Macura, Behram Pastakia, Senator Ben Cardin, Albert Blumberg, Loralie Ma, Mahadevappa Mahesh
MRS Quarterly Update Spring 2013 Page 3
ACR Annual Meeting Highlights
Daniel Seeburg, MD, PhD
continued from page 1
from all across the country. We listened to
lectures on RAD-PAC, and the importance
of engaging our congressmen and
senators to inform them about our
profession. We learned about the state
of radiology, and how within our present
shifting landscape of medicine, radiology
will have to transform itself from a
volume-based practice to a value-added
practice. ACR’s “Imaging 3.0” campaign is
taking the lead in this transition with lots
of good ideas, including providing new
decision-support software based on ACR
appropriateness criteria to assist ordering
physicians and patients in selecting the
most appropriate examination.
MRS Meeting with Maryland Congressional Representative John Sarbanes
Back Row: Chris Trimble, Robert Paley, Behram Pastakia, Dan Seeburg, Albert Blumberg
Representative John Sarbanes, Rebecca Wright, Anand Narayan
Front Row: Serena Liebengood, Katarzyna Macura, Loralie Ma, Mahadevappa Mahesh,
Arvind Sivakumaran
Maryland
Radiological
Society
A related and important point was
made many times over the course of the
meeting: The traditional fee-for service
model will be progressively making way
for value-based reimbursement models.
We heard residents debate the pros
and cons of both systems, and heard a
guest lecture by the chief quality officer
of Intermountain Health Care who has
been a pioneer in outcomes-based
value and patient-centered care models.
One of the highlights of the meeting
was the lunch presentation by Richard
Duszak, CEO of the Harvey L. Neiman
Health Policy Institute (HPI). In a valuebased medical care environment, it will
be incumbent upon us as radiologists to
demonstrate our value and relevancy to
patient care. The HPI is at the forefront
of this endeavor, and is sponsoring and
conducting evidence-based research
projects to study the value and role of
radiology in evolving health care delivery
and payment systems.
Another highlight was our trip to Capitol
Hill on the final day of the meeting. We met
with several of our Maryland congressmen
and their staffers, and discussed how
MPPR policies overestimate perceived
efficiencies within the professional
component and are not supported by
sound data. We also discussed how
our incentives are aligned with those
of Centers for Medicare & Medicaid
Services (CMS) in terms of cutting costs
of unnecessary imaging studies. Towards
that end, we outlined the physician
ordering support tools based on the
ACR appropriateness criteria that ACR is
offering to make available to physicians
in the Medicare program at no cost.
Attending the annual meeting of the ACR
was a memorable experience and I look
forward to attending again next year. In
the interim, we will continue to spread the
word and get more Maryland radiology
residents interested and involved in the
ACR.
Fall 2012
The 2013-2014 ACR Board of Chancellors: Three of MRS members serve on the Board
Albert L. Blumberg, MD, FACR (ACR President), Jonathan S. Lewin, MD, FACR (ARRS Representative & Chair Commission on
Clinical Research and Informatics), Katarzyna J. Macura, MD, PhD (Chair Commission for Women and General Diversity)
MRS Quarterly Update Spring 2013, Page 4
ACOs & Bundled
Payments
Gene Ransom
CEO, MedChi
Presented on May 21, 2013
continued from page 1
Ransom explained that integrated care
delivery models are causing the industry
to shift away from a fee-for-service model
and payors are looking to make fixed
payments to care physicians for treating
a specific patient population. The federal
ACO program is only the beginning
of a larger shift in how care is paid for
nationally.
Meeting with Maryland Congressional Representative Christopher Van Hollen
Back Row: Arvind Sivakumaran, Anand Narayan, Representative Van Hollen, Behram Pastakia,
Chris Trimble, Dan Seeburg
Front Row: Rebecca Wright, Loralie Ma, Serena Liebengood, Katarzyna Macura, Mahadevappa
Mahesh, Robert Paley
Maryland currently has ten approved
privately created ACOs. A federal ACO
must have at least 5,000 Medicare
beneficiaries. Beneficiaries are assigned
based on the location where they receive
the majority of their primary care services.
The federal program provides no required
network or other restrictions and patients
may opt-out. Federal law also requires that
at least 75% of the ACO governing board
must consist of health care providers
participating within the ACO. ACOs must
strive to achieve the 3 CMS goals of better
patient care, improved population health,
and lower costs.
Maryland
Radiological
Society
MRS Executive Board
President
Katarzyna J. Macura MD, PhD
Vice President
Robert M. Stroud MD
Fall 2012
Secretary
Rathan Subramaniam MD, PhD, MPH
Treasurer
Matthew L. Snyder MD
Contact
Gina Sirolli
Advanced Radiology
7253 Ambassador Rd.
Baltimore, MD 21244
[email protected]
(443) 436-1114
www.acr.org/Membership/Chapters/Maryland-Radiological-Society
Albert Blumberg presenting ACR Congressional Award for
Radiological Excellence to Maryland Senator Ben Cardin