Last week, the Radiology Billing Management Association (RBMA) hosted the 2016 Fall Educational Conference, attracting over 200 radiology professionals and leaders to the Hyatt Regency in New Orleans. Attendees were represented from as far away as Alaska, with varying viewpoints on the latest trends in billing management for imaging.  

IMG 0009Being the final Fall Conference for the organization before moving to one annual spring conference next year, RBMA worked hard to provide a program that was beneficial for members while discussing the most recent topics to impact the industry.  Popular educational sessions included ICD-10, cyber security, staffing analytics, business intelligence and data mining, with the main conversations turning towards the many uncertainties surrounding Medicare Access and CHIP Reauthorization Act (MACRA), Medicare Incentive Payment System (MIPS), and Alternative Payment Models (APMs).  Discussions centered heavily on expected timelines and possible implications, and multiple sessions were dedicated to delving into the ins and outs for radiology.  With a lot at stake, it seemed the general consensus was the age-old adage of “prepare for the worst, expect the best.”  One thing was certain – much like ICD-10, no matter when these regulations actually take effect, it will happen at some point or another.

Key Takeaways included:

Start date, January 1, 2017: There are two years between reporting year and associated payment or adjustment, so performance in 2017 will determine payments in 2019.  Notable for smaller radiology groups who have not yet reported under PQRS or experienced payment adjustments

All Medicare payments: 30% through APMs by 2016 and 50% through APMs by 2018.

Quality over quantity: 80% of Medicare fee-for-service payments will be tied to quality by 2016 and 90% tied to quality by 2018. Medicare will be publishing provider performance which should incentivize providers to report quality.

MIPs is a score used for additional incentive payments or penalty adjustments, with a net total of zero dollars: 
Radiologists will probably fall under MIPs more than APMs.  Less than an estimated 4% of participating providers will be paid under the APM track.

The content of your MIPs score will determine bonus or penalty.
- Quality Measures – 30 points (former PQRS)
- Value Based Modifiers – 30 points 
- Meaningful Use (EHR) – 15 points
- Clinical Practice Improvement Activities – 25 points (Expanded practice access, population management, care coordination, beneficiary engagement).

  • Clinical Decision Support: Looks to be implemented in January 2018.  Physicians ordering advanced diagnostic imaging exams (CT, MRI, nuclear medicine and PET) must consult a CDS system that is government approved. o   If clinical decision support does go into effect on January 2018, Imagine will be prepared to receive, maintain, and transmit the CDS value as required for the billing platforms supported.  However, to date, this value has still not been defined. 

bus2      dinner2

ImagineSoftware hosted a Sightseeing Tour around NOLA for clients and friends, followed by dinner at the historic Napoleon House. 

In addition to sessions, the exhibit hall boasted more than 60 booths and offered a variety of products and services to impact the industry.  Attendees received focused time with vendors through exhibit hall breaks, meals, and receptions.  The Imagine team showcased its core ImagineBilling suite at Booth #209, as well as ImagineIntelligence for business analytics, the ImaginePay online patient payment portal, and HonorCare® for patient-friendly financing plans to pay your practice. The exhibit hall was a place to catch up with old friends and meet new ones in between sessions, and relax after a long day with a drink in hand.  Attendees could be heard laughing at stories from past RBMA experiences, thanking sponsors for their participation, and sharing best practices amongst fellow professionals. The opportunity to network appeared to be a huge draw for those who made the trip, seemingly as much as the benefits gained from educational sessions.

With the RBMA 2016 Fall Conference complete and the sounds of jazz in the streets, heavenly smells of fresh beignets, and the sight of colorful, swinging beads New Orleans is best known for fading away, we look ahead to 2017 and the shift to a single, annual RBMA conference – PaRADigm. 

I look forward to seeing everyone in Chicago in April.  Until then, Imagine on, my friends!

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