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Table of Contents
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| Letter from the Editor |
Happy New Year to all of you! We all hope 2022 brings brighter days to all our members and their patients and colleagues. The omicron surge has begun to re-fill our hospitals and exacerbate a situation that was already short-staffed. We hope you and yours stay safe during these challenging times. In November/December we sent out a survey to gauge member opinion on an AAWR resolution on paid family leave. The survey results were split almost cleanly down the middle at approximately 50% in support and 50% neutral or opposed, plus or minus 1%. Without a convincing majority, we felt that remaining neutral on the resolution from a sponsorship perspective was the wisest course of action for now. If increased support occurs between now and the annual meeting, we can revise our position closer to that time. I would like to make a few clarifications regarding the resolution — some comments asked why 12 weeks was chosen as a length of time and how training would be affected. The Family and Medical Leave Act (FMLA) is a federal law that *already* requires 12 weeks of *unpaid* leave for family and medical reasons, as long as the entity meets the criteria for applicability (all public agencies are included, as are private sector employers who employ 50 or more employees). The ACR *already* supports paid leave for trainees “who are in compliance with clinical competency, and Initial Certification requirements as well as in good standing within their program”. The resolution at hand was to ask practices to strive to provide *paid* leave for the same 12 weeks required by the FMLA, instead of unpaid leave. I apologize if there was any confusion. If you have any more questions about FMLA, the Department of Labor has a useful FAQ: Click Here.
Speaking of resolutions, and I hope you all made some terrific New Year’s Resolutions!, you can make resolutions for the ACR Annual Meeting, too! The deadline has been changed to January 31, 2022. More information on writing resolutions can be found here.
For those of you who have not seen the latest ACR Bulletins, there was a recent special edition on incidental findings that I thought was useful. It is available here.
Finally, I would like to draw your attention to the “No Surprises” work the ACR is undertaking. Please see the following press release: Click Here. In short, “No Surprises” laws have the well-intentioned goal to eliminate massive “surprise” out-of-network bills to patients who may, for example, go to a hospital that is in-network but have the anesthesia or radiology group professional fees be out-of-network. However, the legislation is often written in a way to “solve” the problem by tying out-of-network fees to a very low fee schedule, removing the incentive of insurers to negotiate contracts with out-of-network providers and generating a race to the bottom of the price barrel. The ACR has joined the emergency physicians (ACEP) and anesthesiologists (ASA) in a lawsuit to block federal implementation of parts of the No Surprises Act. You can read more here.
Thank you, and Happy New Year!
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Juan Batlle, MD
Secretary, FRS
juancarlos98@gmail.com |
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| Meet Your 2021 – 2022 FRS Executive Committee |
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President
Rajendra Kedar, MD, FACR |
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President Elect
Chintan Desai, MD, FACR
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Treasurer
Laura Vallow, MD |
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Secretary
Juan Batlle, MD |
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| FRS President’s Message |
Happy New Year FRS members and supporters! I wish you love, happiness, health, and success for 2022. I thank you for your support to our Executive Committee and look forward to making 2022 even more successful.
Good, bad, and ugly in 2022 Good: Based on the 2022 Medicare Physician Fee Schedule (MPFS), the final ruling estimates a -1% impact on diagnostic radiology reimbursement across the budget-neutral fee schedule due to changes in relative value units and adjustments to clinical labor pricing across the budget-neutral fee schedule. Thanks to the advocacy efforts of the ACR along with a multispecialty coalition, the impact is less than the 2% reduction in the Proposed Rule and will be phased in over four years. Bad: Interventional Radiology still faces a formidable reduction of 5% which is reduced from 9%. Ugly: Additional cuts threaten radiology via reductions in the conversion factor (CF). We dodged the bullet in 2021 due to the allotment of an additional $3 billion to the MPFS by Congress to mitigate extreme cuts to physicians caused by the revaluation of Evaluation and Management (E/M) codes. However, this one-time cash infusion buffered the CF by 3.75% in 2021. In addition, we may get a 4% cut from Pay-As-You-Go and 2% from Medicare sequestration. Unless Congress Legislative intervenes and infuses another payment, we will have these cuts in 2022. Uncertain Times: On the Merit-Based Incentive Payment System (MIPS) front, there is a planned move to MIPS Value Pathways (MVPs). CMS will have seven initial MVPs that will be available, beginning with the 2023 performance year, and additional MVPs will be added as they are developed. However, in radiology and other specialties whose care is not episode-based, it is unclear how will we participate in MVPs. Radiologists have a particular disadvantage with the MIPS program as the bar gets higher to achieve a positive payment adjustment as we have limited quality measures available. Two of our commonly used quality measures are getting removed – Stenosis Measurement in Carotid Imaging Reports and Reminder System for Screening Mammography. Radiologists simply do not have enough quality measures available to score highly in the Quality category without using Qualified Clinical Data Registry (QCDR) measures. Bottom line: The ACR at the national level and the FRS at the state level continue to fight for our interest. To be successful in our efforts for Radiology and Radiologists, it’s important to support and donate to the ACR RADPAC and the FRS PAC. These are the bipartisan political action committees. Its goal is to support the campaigns of pro-radiology candidates at the federal and state level through voluntary contributions from members of the American College of Radiology Association and the Florida Radiological Society. The success of these is very important as Congress at both levels address many issues affecting radiology such as mammography reimbursement, Medicare reform, patient safety, and medical liability. It is critical for radiology as a profession to have its voice heard on Capitol Hill and Tallahassee through a bipartisan political action committee that supports members of Congress and candidates for federal office who are helpful to the radiology community. Please donate to our PAC.
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Very Respectfully,
Raj Kedar, MD, FACR
President, Florida Radiological Society
Professor of Radiology, University of South Florida – Morsani College of Medicine
Director- Body Imaging Education and Fellowship
Chief -Dept of Radiology, Tampa General Hospital |
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Past President
Douglas Hornsby, MD
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| FRBMA President’s Message |
MGMA a Select Summary of the 2021 Surveys
Medical Group Management Association is an Association that draws members from a wide spectrum of healthcare practices. The members are typically in leadership positions similar to Practice Manager or Executives level. This is probably not on your radar and to be honest I have not attended any of their annual meetings. However, one of the features I really like is their snap surveys. These surveys come as a text to your phone. The text states a question and then gives multiple choice selections as to where your group stands on that particular question. You typically have three or four choices (e.g., Do you have a mask mandate? 1. Yes, 2. No. 3. Considering). To answer the question, you just text back the number that best fits your group. If you answer the question then you are sent the results of the survey (You do not get any results if you did not participate). The results are sent via text and they use graphs and visuals to make the data easy to consume. There are usually around 1,000 practices that participate in each survey and they are fairly frequent. I personally don’t save the results but MGMA texted participants a year end recap of some of the most popular surveys. Here is a sampling from 2021:
- August 3, 2021. Does your practice have a policy for vaccination of employees? 18% Mandatory, 69% Recommend only, 13% no policy.
- August 31, 2021. Will you require vaccination after FDA approval? 46% yes, they will require, 31% no, 23% unsure. Note that this poll was taken after the FDA approval of the Pfizer-BioNTech vaccine was approve
Note that these two pools are only about a month apart but significantly more practices intended to mandate from just a month earlier (46% vs 18%).
- October 5, 2021. Do you have employees who quit or were terminated due to vaccine requirements of the employer? Yes 38%, No 62%.
- December 7, 2021. What percentage of your employees are vaccinated? For those employers surveyed 21% percent said 100% of employees vaccinate, 27% said 95%-99%, 14% said 90%-94% and 38% said less than 90% were vaccinated.
I would say these results were surprising. The level of vaccination is much higher than what I see locally and I not aware of any medical practice, including the hospitals in town, that were terminating employees based on vaccination status back in December.
- March 2, 2021. Have you had a physician unexpectedly retire in the last year? No 72%, Yes 28%
- October 26, 2021. Has your practice had a physician retire early or leave due to physician burnout? No 63%, Yes 33%.
- May 11, 2021. Do you have a formal plan to address physician burnout? Yes 14%, No 86%
These questions are similar and about 7 months apart. I felt the rate of unexpected departure is higher than I would expect. Is there something we should be doing to engage physicians in a discussing this topic? Is this just pandemic related? Only 14% of groups are addressing this issue.
- September 21, 2021. What is you biggest pandemic challenge? Staffing 73%, Uncertainty 15%, Cost/revenue 10%, other 3%.
- March 9, 2021. Are you currently recruiting physicians? Yes 72%, No 28%
- May 4, 2021. Are you having difficulty hiring medical assistants? Yes 88%, No 12%.
- June 8, 2021. Did you increase benefits this year? Yes 26%, No 74%.
- June 22, 2021. Did you increase hiring benefits in 2021 (Signing bonus, moving allowance etc.)? Yes 33%, No 67%
These are all related and staffing issues are very similar to what is going on in our market. We have taken steps to significantly increase the wage scale for all employees and particularly those where their skill set that is very transferable to other industries. Many of the employees we lose are leaving healthcare for a job they feel is safer and less stressful. We also did a 6% cost of living increase this year which is double what we did in prior years.
- September 7, 2021. How did summer volumes change during summer/Delta variant spike? Decreased 15%, Increased 42%, stayed the same 43%.
I think if this was just radiology practices you would see a much higher result for decreased volume. Non-radiology medical practices have better adapted or are more able to adapt to telemedicine.
That’s a sample, I hope you found it interesting. You do not have to be a member to participate but a member needs to send you a link so you can register. It has been so long ago that I signed up and I don’t recall what the sign-up entails but I know there are no fees for participating,
I wish you all a happy, productive and fulfilling 2022. |
John Detelich, CPA, MBA, CEO
President, FRBMA
jdetelich@radassociates.com |
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| Legislative Update |
Happy New Year! The Legislature commences its sixty-day session on January 11th ending March 11th. The Omicron variant is spiking in Tallahassee with an anticipated three-week period of illness ahead, per local experts. To date, there are no announcements regarding limitations on the public going into the Capitol for session. Senate President Simpson stated they would let science dictate whether some of the previous safety protocols need to be reinstated.
The Governor has released his 99.7-billion-dollar budget, and the revenue estimating conference recently announced there was 400 million new monies in recurring revenue which is a great budget boost.
The bills are starting to hit the system and as anticipated more scope of practice expansion bills are in the mix. To date, the anesthesiologists have a bill modernizing the regulation of anesthesiologist assistants that the certified registered nurse anesthetist are opposed to. The CRNA’s are anticipated to have their own bill giving them further autonomy as well. There are several bills relating to mammography which the Breast Imaging Committee is reviewing and working on. It will be a busy session with reapportionment overshadowing it all.
Of note, Congresswomen Stephanie Murphy, Orlando, has announced that she will not seek re-election. The latest political domino to fall.
I hope everyone stays safe and well. If you have any questions regarding the upcoming session, please do not hesitate to contact me at alisondudley@dudleyandassociates.com. |
Thanks, and stay well.
Alison Dudley, FRS Lobbyist
AlisonDudley@dudleyandassociates.com |
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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 2022 Annual Meeting in Amelia Island, Florida, July 15-17, 2022 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 16, 2022 in order to be considered for this award.
Thank you,
Jeffrey Stone, M.D., FACR
President, FRS Educational Foundation |
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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.
Phone: (813) 806-1070
Fax: (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 |
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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. Thank you for your donation: Dr. Mergo
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
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| 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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