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Why Join the ACR (page 4)

IV. Economics

The ACR has commented extensively on the new Hospital Outpatient Prospective Payment System (HOPPS) and its relative weights known as Ambulatory Payment Classifications (APCs) effective August 1, 2000. The ACR will continue to monitor the groupings of radiology procedures into APCs and the values assigned for the technical component of outpatient procedures.

In addition, the ACR commented extensively on the new "units of service" edits implemented by HCFA on July 1, 2000. These edits limit the frequency by which any radiology or radiation oncology procedure may be coded for a patient in one day even with the use of a modifier.

The ACR Practice Expense Committee was formed with representatives from each of the subspecialty economic committees. This committee will formalize a mechanism for making recommendations through collection and evaluation of expense data and the comparison of that data to the existing Clinical Practice Expert Panel (CPEP) data.

The ACR met with HCFA personnel to request their assistance in clarifying the "ordering of diagnostic tests rule" (HCFA regulation 410.23) and the "ICD-9 coding guidelines". HCFA has agreed to formalize, in writing, the intent and interpretation of the regulation to eliminate any ambiguity.

The CPT Editorial Panel accepted the addition of 26 new and the revision of 58 existing CPT codes as proposed by the ACR at its February 2000 meeting in Chicago.

As part of the CPT V Project, the ACR CPT Advisor and the Coding & Nomenclature Committee have reviewed and made recommendations for editorial revision to CPT to further standardize and enhance the CPT descriptors.

In addition to the standard RUC (Relative Value Update Committee) cycle, the ACR is working on the second congressionally mandated "Five Year Review" of all CPT codes. This review is limited to reassessment of the physician work value component.

The ACR's CAC (Carrier Advisory Committee) Network is made up of approximately 200 radiology and radiation oncology volunteers who spend countless hours attending Medicare Carrier Advisory Committee meetings, drafting and commenting on radiology and radiation oncology policies. These policies, known as local medical review policies (LMRP), affect radiologists' and radiation oncologists' reimbursement for procedures at the state level. The unique relationships that the ACR CAC representatives have with their Carrier Medical Directors (CMDs) have been successful in negotiating fair reimbursement policy at the local level as well as acceptance of ACR accreditation programs in many of these policies.

ACR staff has confirmed all 50 liaison nominations to the Managed Care Network. The Network will determine needs to effectively deal with Managed Care Organizations (MCO) utilizing the newly created on-line forum.
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V. Resident Support

To further support the transition of residents into practice the ACR and APDR began the development of a 7-part video series. The videos focus on non-clinical skills development and practice issues. The first six videos have been sent to all program directors and ACR chapters.

The annual ACR In-Training Examinations (Diagnostic and Radiation Oncology) are intended to improve insight into the overall effectiveness of the resident in-training program, both to the participating resident and the program director. The Diagnostic examination is held in February and the Radiation Oncology examination is in March. Starting January 1, 2000, the College drastically reduced its member fees for members transitioning from training to practice.

VI. Education

The ACR Education Department, under the direction of the Commission on Education, awards CME credits through a broad array of educational symposia and products (available in print, video, and CD-ROM formats). Included among these are the National Conference on Breast Cancer, the recently developed Cardiovascular Imaging Conferences, and the ACR Mammography Symposium. Also offered are self-evaluation programs such as the Mammography Interpretive Skill Assessment Examination and the Continual Professional Improvement (CPI) subscription series. A new feature launched in the July 1999 issue of the ACR Bulletin is the "Knowledge Challenge", aimed at enhancing knowledge and skill areas concerning complex cases in radiology. The Education Department also grants CME credit for jointly sponsored and co-sponsored radiology educational activities with other academic institutions.

VII. Research

The ACR initiated ACRIN, the American College of Radiology Imaging Network, the first standing collaborative clinical trials group in diagnostic radiology. ACRIN will permit more rapid and extensive conduct of high quality, multi-center clinical trials than has previously been possible. Nine protocols are in various stages of development.

TASAP, a program to enhance clinical research by providing to individual investigators without charge assistance they require in statistical analysis, data management, and study design for important research studies, was initiated.

As part of the ACR's mission of providing information important to the profession, in the last year the research staff published 10 major papers in leading diagnostic radiology and radiation oncology journals.

A study of radiologists' workload measured in RVUs was completed and published in Radiology.

Its data answers the question the ACR research department is most frequently asked, "What is the workload of a radiologist?" A study of practice costs in diagnostic radiology practices will appear shortly in Radiology; a similar study of radiation oncology practices has been completed and submitted to for publication.

In response to growing legislative activity related to self-referral, the ACR stepped up research activity in this field. The past year saw ACR involvement in multiple self-referral research studies. Three were published in AJR or Radiology and several others are scheduled for presentation at RSNA in 2000.

The ACR conducted a large-scale survey of radiology practices in 1999 designed to address issues of importance to the profession. Data analysis and publications of results are underway.

The ACR completed a study of the use throughout the American health care system of quantitative standards for procedure volumes and the sources of these standards. Results are used to guide ACR's standard-setting processes.

The future of radiology rests with those willing to make an investment. Invest in the ACR. It will be one of the wisest decisions you will ever make.

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