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Edition: February 2020 |
Table of Contents |
Letter from the Editor | FRS President’s Message | FRBMA President’s Message | Legislative Update More Legislative Update | Martin Northup Resident Leadership Award 2020 Annual Meeting of the FRS &FRBMA | Job Board | Job Posting Opportunities Become a PAC Member |
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Letter from the Editor |
As we start the new year, our workload continues to increase and so does the rate of burnout. Interesting article on burnout that includes the following: “I was once quite sick, but we were very short staffed so I went to work and read films, hooked up to an IV. And no one around me thought that was odd,” says the national board-certified health and wellness coach, founder of Lifestyle Health LLC, and clinical instructor in lifestyle medicine at Stony Brook University Medical Center in Stony Brook, New York. Full article – click here. What do experts recommend Five tips to avoid burnout
- Don’t be hard on yourself. There is no one right way to prevent burnout. It usually takes some time to develop a list of strategies and to try them out before you work out what is best for you and your lifestyle.
- A crucial first step when preventing physical and emotional exhaustion is prioritizing healthy eating, exercise, and better sleeping habits. Be intentional about scheduling time in your diary to do a physical activity at least once a week.
- Don’t be afraid to set boundaries at work by clarifying expectations and responsibilities. Learn to say no. It’s impossible to be everything to everyone. Besides, saying ‘no’ means you can say ‘yes’ to the things that you want to do.
- Get support. When you are overwhelmed or stressed there can be a natural tendency to disconnect from people and isolate yourself. Speaking to people you trust, and who care about you, can help you gain fresh perspective.
- Perfectionism and burnout go hand in hand. We live in a world dominated by the pursuit of perfection and it is easy to translate this into our work life. It makes us too self-critical when completing tasks. Write down what is most important to you to achieve — and get into the habit of prioritizing those tasks.
Artificial Intelligence-https://lunit.io/en/ A company based in Korea has developed algorithms/platforms that can aid Radiologist. Lunit’s Chest Radiography and Mammography solution shows 97-99% and 97% accuracy, respectively. They aim to achieve 99% accuracy. Lunit INSIGHT CXR 3 product accurately detects 10 of the most common findings in a chest x-ray, which includes atelectasis, calcification, cardiomegaly, consolidation, fibrosis, mediastinal widening, nodule, pleural effusion, pneumoperitoneum, and pneumothorax. Radiology imaging findings for patient infected with CoronaVirus, Unenhanced CT images shows multiple ground-glass opacities in bilateral lungs. CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia- Imaging findings on CT https://pubs.rsna.org/doi/10.1148/radiol.2020200236
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Chintan Desai, MD Secretary, Florida Radiological Society desai@desairadiology.com |
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Meet Your 2019 – 2020 FRS Executive Committee |
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President Patricia Mergo, MD, FACR |
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President-Elect Douglas Hornsby, MD |
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Treasurer Rajendra Kedar, MD, FACR |
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Secretary Chintan Desai, MD |
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FRS President’s Message |
This has been a very active month and I would like to take the opportunity to update you on some highlights from the FRS winter board meeting.
First, I would like to thank all those in attendance at the winter board meeting including several new Individuals who have stepped up and are lending their great talents in new ways for the society.
I would also like to thank those who continue to lend their support and talents in many ways that off and go unrecognized.
Thank you to the groups in Florida who have stepped up and donated to the Foundation and sponsors lectures at the FRS meeting this summer including: Digital radiology, Radiology Imaging Associates, Radiology Associates of Tallahassee and Radiology Associates of Florida. We appreciate your investment in the future of radiology in the state of Florida.
I am currently in Tallahassee Florida with Alison Dudley and three of our resident trainees from across the state. Allison is graciously providing us invaluable insight into the legislative process in Tallahassee. One thing is certainly clear in being here and that is that our efforts do make a difference.
I also had the wonderful opportunity to attend the FRBMA winter meeting In St. Augustine. Thank you very much to the FRBMA for inviting me and offering this forum for education and interaction. I would encourage others to attend the FRBMA meeting if you have the opportunity. It was a fantastic meeting!
One of the things that was a focus for discussion at that meeting was the proposed 2021 Medicare physician fee schedule changes that would result in a radiology services reimbursement cut of approximately 8%. My hope is that this will still be open for discussion when we are on the hill in May with the ACR. Please join us if you can.
Finally, I would like to congratulate and welcome Dr. Laura Vallow as the new incoming Secretary of the FRS in July. We thank you for all your hard work with the FRS and we look forward to working with you Laura! Thanks! |
Patricia Mergo, MD, FACR President, Florida Radiological Society Mergo.Patricia@mayo.edu |
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Past President Steven DePrima, MD, FACR |
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Legal Counsel Michael M. Raskin, M.D., J.D., FACR |
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FRBMA President’s Message |
The Centers for Medicare and Medicaid Services (CMS) released the CY 2020 Revisions to Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies, which includes changes to the Quality Payment Program (QPP) effective for services on or after January 1, 2020. The final regulations were published in the Federal Register on November 15, 2019.
Highlights include:
The weightings for the performance categories remain unchanged and, if all categories are applicable, are as follows:
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CMS has postponed increasing the Cost category to 20 percent and agrees they have yet to provide adequate industry data to drive any increase. Despite this delay, the anticipated weighting for the Cost performance category in 2022 is 30 percent.
The threshold for avoiding a negative payment adjustment increases from 30 in 2019 to 45 and the exceptional performance threshold increases from 75 to 85. By statute, the maximum payment adjustment increases to up to +/- nine percent and the projected positive payment adjustment for a composite performance score (CPS) of 100 is 6.25 percent. This is all great news for high performers! Perhaps the most important changes in the Merit-based Incentive Payment System (MIPS) are the advancement of “topped out” measures. As measures are devalued and removed, it is imperative for clinicians to be developing workflows for the reporting of measures that are not topped out. Of note, the industry expected measure 225, Reminder System for Screening Mammography, and measure 146, Inappropriate Use of Probably Benign, both which were devalued in 2019, to be deleted from the Program. However, both will remain in the Program in 2020 as deleting them would have left the modality of mammography with very few choices. And both have increased in value to 10 points in 2020.
An important change in the Improvement Activities performance category is 50 percent or more of all clinicians in a group must now perform the same Improvement Activity for any continuous 90-day period. This compares with only one clinician performing an activity for a continuous 90-day period in prior years.
CMS has made major changes to the Cost attribution logic for the Total Per Capita Cost (TPCC) and Medicare Spend Per Beneficiary (MSPB) measures. The change to the MSPB measure means the only patients likely to be attributed to a radiology group are Interventional Radiology cases where the radiologist performs the primary procedure that is required for the patient to be admitted. Radiologists will not be responsible for the cost of medical admission cases where only diagnostic services were provided.
The changes to the TPCC measure exempts both diagnostic and interventional radiologists, which is also good news! However, groups that utilize Physician Assistants and Nurse Practitioners for the provision of Evaluation and Management services in an outpatient setting where the patients are seen more than once in a 90-day period are subject to this Cost measure. It is important to review your billing data and to assess if you want to utilize PAs and NPs differently to reduce the risk of triggering this Cost measure.
And a topic for a future e-Brief – CMS’ introduction of MIPS Value Pathways (MVPs), a conceptual framework that provides the industry with predetermined measure sets that apply to each specialty or patient condition, e.g. diabetes. CMS’ stated goal in developing MVPs is to reduce the burden on clinicians and to improve their ability to compare performance across clinicians. So stay tuned! |
Barbara Rubel, MBA, FRBMA President, FRBMA brubel@msnllc.com |
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Legislative Update |
The Legislature is about to enter the fourth week of the Legislative Session and the Florida House has continued its assault on the House of medicine and the hospital industry.
Rep. Dr. Pigman has filed his scope of practice expansion bill which would allow independent practice for PA’s and APRN’s. This bill is moving through the House. There is no companion measure to this bill in the Senate but it is widely speculated that it will be one of the trade issues this Session. Under Senate Rules since the issue has not been filed in the Senate it can be amended onto a germane bill which there are several moving. Also moving is a bill that would allow pharmacists to test and treat for flu and strep. There is a balanced billing bill addressing air ambulance services. Rep Renner has the bill that deregulates many things including physicians, rad assistant, rad techs to list a few. The plan would be to legislatively review these chapters and if not re-enacted by the Legislature the act’s sunset. This bill has a companion measure in the Senate filed by Senator Diaz but it has not moved. The House bill is anticipated to move as Rep Renner is in line to be Speaker after Speaker designee Sprowls.
The budgets of both houses have been rolled out and in the upcoming week they will vote on their budgets and agree to disagree. At the moment they are $1.4 billion apart.
The budget negotiations are part of the legislative trades. It is an election year so folks will not want to go into overtime and at the moment that is not anticipated.
Session ends March 13th so there still is a lot of time on the clock for things to happen. |
Thanks, Alison Dudley, FRS Lobbyist AlisonDudley@dudleyandassociates.com |
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More Legislative Update |
As you have most likely seen and hopefully not ignored, there are major legislative efforts underway in both Washington and Tallahassee that could have serious effects on our practices. Please make every effort when are you are sent an email with the option to send a message to a legislator via an embedded link, to do so. The number of responses that the legislative offices receive is tallied and can make a difference.
Surprise medical bills: While legislatively dealt with in Florida in 2016, the battle lines have moved to Washington where the insurance lobby is working with extreme diligence to create legislation that would seriously undermine all network contracts. There is every reason to believe that the suboptimal bill passed in Florida in 2016 could be overridden by a worse bill in Washington. As described in a previous E-Brief, this legislation is not just about a small number of patients getting large out of network bills. It is all about physicians being strangled by the insurance companies while trying to negotiate a reasonable in-network contracted rate. Due to effective PR, the insurance lobby has gained the upper hand but we are making progress through the aggressive response of medical societies, physician service company representation, and individual physicians contacting their legislators. Do not assume that someone else is taking care of this for you.
Medicare fee schedule: There have been severe cuts proposed in the 2021 Medicare physician fee schedule that would result in a decrease in radiology services reimbursement of approximately 8 percent (Do the math). The rationalization is based on an increase in the payment for E/M (evaluation and management) codes that requires an offset by other codes to remain budget neutral, with a very disproportionate negative effect on radiology reimbursements. This devaluation will certainly trickle from Medicare to most private contracts, since most are based on a percent of Medicare. So unless you think you are overpaid, look for opportunities to send your comments on this issue to your federal office holders as well.
Independent Practice: Of somewhat less direct relevance to radiology, there is active pressure from Florida House leadership to pass a bill granting significant expansion in the unsupervised practice of mid-level providers. It is early in the session, details are not yet available, and it is hoped that this is not likely to result in an expansion of mid-level providers into the diagnostic imaging realm. Due to work we had performed a number of years ago, the FRS crafted legislation that restricted Radiology Assistants to non-image interpretation work. However, that does not guarantee encroachment by mid-level practitioners not licensed as Radiology Assistants. Further, it would be very shortsighted not to support those specialties more likely to see encroachment now. As with the proverbial camels nose under the tent, this effort to cheapen medical care at the expense of quality is likely to eventually find us.
Within the next few weeks, you will likely be seeing “Calls to Action” from the ACR, FMA, FRS, or other subspecialty organizations. Please take note of them, and respond when asked. Again, please feel free to disregard all of this if you think you are overpaid. |
Thanks, David H. Epstein, MD, FACR |
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Martin Northup Resident Leadership Award |
H. Martin Northup Resident Leadership Award – A scholarship opportunity for Florida Diagnostic Radiology, Radiation Oncology and Medical Physicist 2nd year Residents or graduate students.
Martin Northup was very committed to radiology resident education and advancement. To eternally honor and remember him, the board of the FRS Foundation has established a special award bearing his name, the “H Martin Northup Resident Leadership Award.” Each year, this award will be given to a 2nd year Florida radiology resident who will be a 3rd year at the time of the fellowship to support the cost of accommodations for attending the FRS annual summer meeting. The resident will have an officer mentor and will attend all functions including the board meeting. The goal is to develop future leaders in Radiology and develop promising residents to assume greater roles in the society, such as President of the Resident and Fellow’s Section. The award recipient will be chosen for the 2020 Annual Meeting in Fort Lauderdale, Florida, July 17-19, 2020 by the Scholarships and Grants committee based on a competitive application process.
Please click here to download an application. Return your completed application to lroger@edusymp.com by May 15, 2020 in order to be considered for this award. |
Thank you, Jeffrey Stone, M.D., FACR President, FRS Educational Foundation |
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2020 Annual Meeting of the FRS & FRBMA |
Please join the Florida Radiological Society and the Florida Radiology Business Management Association for the 2020 Annual Meeting at The Westin Fort Lauderdale Beach Resort, July 17-19, 2020. The meeting will focus on “2020 Vision: Surviving and Thriving” and will feature lectures by faculty who are leaders in the practice of radiology. We look forward to seeing you in Fort Lauderdale, Florida. |
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Job Board |
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Available Positions
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Job Posting Opportunities |
Florida Radiological Society is pleased to introduce the opportunity for interested parties to advertise for potential jobs in our monthly FRS Ebrief bulletin.
Advertisement pricing is as follows:
Ebrief Job Posting pricing: 3 months ($100 monthly) 6 months ($90 monthly) 12 months ($80 monthly)
Please contact Lorraine Roger, our Society Administrator for further information on how to advertise in our monthly publication.
ph (813) 806-1070 fx (813) 806-1071 email lroger@flrad.org
We feel that this will provide a valuable service to both our members and our Florida community of Radiology.
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Thank you for your interest! Patricia Mergo, MD President, FRS
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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.
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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Telephone (813) 806-1070 • Fax (813) 806-1071 5620 W. Sligh Avenue • Tampa, Florida 33634 |
The E-Brief is an exclusive member benefit of Florida Radiological Society, delivering monthly member, chapter and industry news. Please do not reply to this automatic e-mail. For comments or questions about the E-Brief, please contact lroger@flrad.org. |
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