Published on the Feb. 27, 2015, DiagnosticImaging.com website
Editor’s Note: It’s no longer enough for radiologists to be imaging experts. Health care is becoming big business and radiologists need to understand how to navigate the system. Diagnostic Imaging’s Business of Radiology series provides radiologists with the business education they need to succeed.
By Whitney L.J. Howell
Ask any of your peers, and they’ll likely agree – health care as you’ve known it is changing. The patient population has ballooned under the Affordable Care Act. Larger practices and health systems are gobbling up competitors. And, reimbursement dollars are tighter. It’s never been more important to make yourself stand out from the crowd.
Maybe you’ve had a marketing plan for years. Maybe the concept is new to you. Either way, industry experts said, it’s a crucial – and mandatory part – of maintaining a successful radiology practice.
“Radiologists are continuously marketing themselves, whether they recognize it or not. We are at a critical crossroads in our profession, with health care reform and dramatic changes in the health care industry,” Reginald Munden, MD, DMD, MBA, chair of the Houston Methodist Hospital radiology department, wrote in the February Journal of the American College of Radiology. “Radiologic services are in the crosshairs because of the expenses to patients, hospitals, and third-party payers. Perhaps we have done a poor job of marketing ourselves and our profession.”
That’s why, he said, radiologists must improve their marketing for the specialty to survive and flourish.
To read the remainder of the article at its original location: http://www.diagnosticimaging.com/articles/business-radiology-marketing?GUID=EF943FEE-BD0C-44C7-A1BC-C82F32210979&XGUID=&rememberme=1&ts=27022015
Published on the North Carolina Health News website in February 2015
Regulations that give local law-enforcement officers the authority to act on federal immigration laws could have a chilling effect on the use of health care services within Hispanic communities.
By Whitney L.J. Howell
The health of North Carolina’s Hispanic newborns could be at risk from an immigration law.
The federal Immigration and Nationality Act – the same law that led to a racial profiling lawsuit against the Alamance County Sheriff’s Office in 2012 – could also be having a negative impact on the health of unborn babies in North Carolina’s Hispanic communities, according to new research from Wake Forest University.
According to researchers from Wake Forest’s School of Medicine, the heightened fear of deportation generated by this and other laws, in addition to Latinos’ lack of understanding of their rights under immigration laws, has played a role in the unwillingness of North Carolina’s pregnant Hispanic women to seek out the medical services they need.
The study reveals these women are less likely than women of other ethnicities to receive timely and sufficient prenatal care.
“Regardless of the status of the mother or father, a child born here is an American citizen under the Constitution, and we would hope that all children born in this country are healthy and can avoid preventable illness,” said Mark Hall, a Wake Forest law professor with expertise in health care law and public policy who participated in the study. “So it’s certainly important that all expectant mothers receive adequate prenatal care.”
Delaying prenatal care
But that’s not what’s happening, Hall said.
Based on a data review and personal interviews conducted in 2012, Hall and his fellow researchers discovered approximately 30 percent of Hispanic women in North Carolina don’t start prenatal care until after the first trimester.
The American Congress of Obstetricians and Gynecologists recommendations suggest the initial visit occur between eight to 10 weeks. In comparison, according to the same study data, only 10 percent of non-Hispanic women delayed receiving care. Additionally, 30 percent of Hispanic women – versus 8 percent of all other women – received less than half of the 14 doctor examinations recommended in ACOG guidelines.
Unfortunately, said Angeline Echevarria, executive director of El Pueblo, a Latino community-advocacy group, North Carolina’s Hispanic residents often forego preventive health care services out of fear associated with their citizenship status.
“We’ve found that when community members feel they’re being singled out or targeted by law enforcement, it puts a damper on their willingness to seek health services that aren’t associated with any type of emergency,” she said. “We see this especially in rural areas where public transportation isn’t really an option. A lack of good mobility options limits their willingness to drive around and take a chance for what they deem as unnecessary care. So they put off preventive services, even though we don’t recommend it.”
Although N.C. Healthy Start reports first-generation Hispanics maintain the state’s lowest infant mortality rate – 3.7 per 1,000 live births – pregnant women in this community still face risks if they don’t receive proper medical services. Inadequate prenatal care has been linked to low birth weight; neural tube defects, such as spina bifida; congenital illnesses, impaired heart and brain development; and increased infant mortality. Newborns who don’t receive proper prenatal care are 40 percent more likely to die within the first month of life, according to the Guttmacher Institute.
It’s also possible, Hall said, that this group’s rate of inadequate prenatal care could create a significant public health issue for North Carolina. Based on 2013 U.S. Census Bureau estimates, there are more than 875,000 Hispanics in North Carolina, nearly 9 percent of the state’s population.
Effects of the law?
Using vital records data from 2012, six focus groups, and 17 in-person interviews, the study analyzed how expectant Hispanic women accessed and used prenatal care services for nine months before and nine to 18 months after the Immigration and Nationality Act went into effect. The researchers reviewed data from seven counties that adopted the law and seven that didn’t.
Under the INA’s section 287(g), U.S. Immigration and Custom Enforcement can effectively deputize state and local agencies, giving them the authority to uphold federal immigration laws during routing law-enforcement activities. The U.S. Department of Justice cited traffic stop data to argue that the Alamance County sheriff’s department was being overly aggressive in targeting Latinos under the aegis of the INA.
In 2012, federal officials terminated the county’s participation in the program. This past year, Terry Johnson, the Alamance County sheriff, was tried in a federal court on charges of discriminatory policing. A judge has yet to rule in the case.
Researchers can’t say definitively whether immigration regulations caused the drop in access of prenatal care services, Hall said, but the data did indicate fewer women sought care after its enactment than before.
In the interviews, pregnant women frequently reported a lack of insurance contributed to their foregoing prenatal care.
Data from the Henry J. Kaiser Family Foundation reported 43 percent of N.C. Hispanics don’t have health insurance. This amount mirrors the Pew Research Center statistic of 43 percent of Hispanic 18-to-64-year-olds nationally who are without health insurance.
For some women, transportation was an issue, Hall said. Many were concerned they would be pulled over en route to the doctor’s office for a routine traffic violation and have their immigration status discovered. This is what happened in Alamance County, where a review of traffic stops showed deputies from the sheriff’s department were more likely to stop Latinos for minor traffic violations, such as riding without a seat belt.
Another group of women in the study feared the doctor would report them to immigration officials.
To combat these concerns, North Carolina’s public policy and medical leaders must improve communication around patients’ rights and access to care, Hall said. Greater clarity about whether immigration enforcement can even affect medical care – medical providers are neither required nor expected to check immigration status when providing services – could also be helpful.
In addition, he said, knowing there’s no real risk of being reported by the doctor’s office could encourage more women to find some type of reliable transportation to their appointments.
Ultimately, Hall said, improving prenatal care for Hispanic women could have a positive impact on North Carolina’s health overall.
“As a society, we have concern over everyone’s health, particularly those of children. If reluctance or fear affects the willingness to get immunizations, it could impact communicable diseases,” Hall said. “In general, there’s a larger implication. We need to think beyond just enforcing immigration policy to the labor and economic impacts on families, as well as the public health impacts that aren’t fully recognized.”
To read the article at its original location: http://www.northcarolinahealthnews.org/nc-research-news/
Published on the DiagnosticImaging.com website on Feb. 19, 2015
By Whitney L.J. Howell
You have reimbursement woes. You worry about your billing practices. You wonder if you’re doing the right things to demonstrate your value to partner hospitals. The daily stresses can be nearly overwhelming – but, if you were a perfect radiology group, these worries wouldn’t exist.
The perfect radiology group has tweaked its day-to-day activities. Their streamlined coding process ensures proper payment. Their targeted marketing attracts more referring physicians, and personnel tactics secure a seat at the administrative decision-making table. Every day, for the perfect radiology group, operations are smooth.
But, is the perfect radiology group really attainable? Not really, industry experts acknowledge, but it’s possible for you to get close. Later this year, the American College of Radiology (ACR) will release a road map for creating your “optimal” radiology practice or department. In it, according to Mark Bernardy, MD, chair of the ACR Managed Care Committee, you’ll find a list of best practices that were tested at the ground level, and can help you on your way. Consider it an expansion of ACR’s Imaging 3.0.
“Imaging 3.0 has laudable big picture ideas. Everyone nods their head that it sounds good and right. But, then, exactly what is it that you want me to do?” said Bernardy, who is also a practicing Georgia-based radiologist. “There’s a big gap. I thought it would be useful to go through the exercise of writing down what it is we mean when we say, ‘This is what the perfect radiology group looks like.’”
As a compilation of best practices gathered from large medical centers and small private practices nationwide, it will be a living document, open to modification with new, effective ideas, he said.
Read the remainder of the story at its original location: http://www.diagnosticimaging.com/practice-management/how-be-perfect-radiology-group?cid=tophero
Published on the Jan. 15, 2015, DiagnosticImaging.com website
By Whitney L.J. Howell
Unnecessary imaging and appropriateness criteria. These two phrases have dominated radiology discussions for the past several years. It’s a complicated topic that has an even more complex, and elusive, answer.
And, according to industry leaders, one of the most critical components to the discussion is the role radiologists play in limiting the number of unnecessary and duplicative imaging studies performed.
“Radiologists get painted as these selfish people who are self-interested and who are going to fight against change,” said Jeremy Bikman, chief executive officer for peer60, a big data survey company that provides analysis based on conversations with on-the-ground professionals. “But, they didn’t create their reimbursement structure. It comes from the Centers for Medicare & Medicaid Services, and radiologists are just doing the best they can.”
That performance includes responding to and meeting referring physicians’ needs and desires, which, frequently, he said, can be wasteful. A recent peer60 report puts the nationwide cost of unnecessary imaging between $7.47 billion and $11.95 billion annually.
To reach the article in its entirety at its original location: http://www.diagnosticimaging.com/practice-management/what-can-radiologists-really-do-about-unnecessary-imaging
Published on the Jan. 12, 2015 DiagnosticImaging.com website
By Whitney L.J. Howell
CHICAGO — For several years, there’s been a push in health care – particularly in pharmaceuticals – toward personalized medicine. By using a patient’s genetics to better target their medications and therapies, the medical industry has achieved improved patient outcomes.
But, what if you could launch individualized care at an earlier stage – at the point of pathological diagnosis? According to radiology and pathology experts at the 2014 Radiological Society of North America annual meeting, this could be the next wave that takes personalized medicine to the next level.
“The idea is to personalize how we treat patients based on their unique characteristics,” said Mitch Schnall, MD, PhD, radiology department chair, University of Pennsylvania. “The idea of developing data that characterizes someone really gets to the heart of what diagnosis is about. It’s crucial to realizing any benefit.”
To read the article in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/radiology-and-pathology-time-integrate
Published on the Dec. 3, 2014, DiagnosticImaging.com website
When it comes to big data, health care doesn’t really have any. And, for radiology, that’s a good thing. Small and medium data will work just fine – especially for testing and designing new reimbursement models, according to speakers at this year’s Radiological Society of North America (RSNA) meeting.
Industry experts at this year’s RSNA say the data hospitals and health care systems already have can help providers identify ways to maximize their influence in the design of any future payment models.
“We’re currently in the lowest life form of payment policy. We get paid for events – it’s a transactional delivery system,” said Richard Duszak, MD, vice chair for health policy and practice, department of radiology and imaging sciences, Emory University School of Medicine. “Increasingly, we’re moving to models where we’ll be paid by encounters and engagements.”
The question, he said, is how those models will be designed to ensure radiologists receive appropriate reimbursement for services rendered in a correctly incentivized way. To date, there’s no clear-cut answer, but there are steps radiologists can take – armed with small-to-medium data – to ensure their seat at the decision table.
To read the article in its entirey at its original location: http://www.diagnosticimaging.com/rsna-2014/no-such-thing-big-data-health-care
Published on the Dec. 16, 2014, DiagnosticImaging.com website
By Whitney L.J. Howell
CHICAGO — It has been six years since the Radiological Society of North America (RSNA) launched its Reporting Initiative. In that time, radiologists across the country have benefited from the tools it offers, according to the Initiative’s leaders and other industry experts, who revealed its accomplishments to date and discussed what’s yet to come.
“Our goal, in part, was to improve the quality of radiology reports, making it easier for referring physicians, patients, and other radiologists to use and have the information that we can extract from reports,” said Charles Kahn, MD, chair of the RSNA’s Radiology Informatics Committee Structured Reporting Subcommittee. “We wanted to develop a better, more robust system that could go beyond speech and voice recognition and really empower the capture of information as radiology becomes more quantitative.”
Rather than dictating to radiologists and practices exactly how they were to create reports, this initiative was designed to collect a sampling of best practice templates that providers could modify to meet their own needs, he said.
To read the article in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/rsna-collaborates-sets-improve-radiology-reporting
Published on the Dec. 22, 2014, DiagnosticImaging.com website
By Whitney L.J. Howell
CHICAGO — With the roll-out of the Affordable Care Act (ACA) still ongoing and the move toward some type of accountable care organization model still underway, it’s unclear how radiology will fare in any medical malpractice lawsuits.
But, industry experts at this year’s Radiological Society of North America meeting all point to one key component of financial survival – communication. Communication with referring physicians, the patient, and each other.
“You have to remember there are three factors to communication – the referring physician, the radiologist, and the patient,” said Leonard Berlin, MD, a radiologist with NorthShore University Health System. “Communication is the link between all three. It’s obviously a real problem when there’s a failure to communicate emergency or acute findings, but it’s significant that there’s a large amount of significant and unexpected findings that don’t get communicated either.”
To read the article in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/avoid-malpractice-radiologists-must-communicate
Published on the Dec. 24, 2014 DiagnosticImaging.com website
By Whitney L.J. Howell
CHICAGO — The buzz about clinical decision support and the need for appropriateness guidelines isn’t new, but implementing and using such tools correctly will soon become even more critical.
According to industry experts at this year’s Radiological Society of North America annual meeting, if your referring physicians don’t master their clinical decision support (CDS) and use it consistently, it’s going to cost the radiologists money.
As of Jan. 1, 2017, said Ramin Khorasani, MD, vice chair of the Brigham & Women’s Hospital radiology department, under the Protecting Access to Medicare Act, radiologists won’t be paid for outpatient, non-emergent services rendered if their claims don’t include a number that proves the referring physician consulted a CDS tool.
But it still isn’t clear how radiology can best teach other providers about diagnostic imaging appropriateness. A recent pilot initiative, the Medicare Imaging Demonstration (MID), showed some improvement in how referring physicians prescribed imaging, but many doctors and surgeons reported dissatisfaction with the CDS software.
To read the article in its entirety at its original location: http://www.diagnosticimaging.com/rsna-2014/why-radiologists-should-care-about-clinical-decision-support