Advancing the Business of Radiology
The leading professional organization for radiology business management professionals in any radiology setting.
X

Welcome, Leaders!

As a practice leader, you have come to the right place for radiology business professionals who are dedicated to supporting and enhancing their vocation, investing in their career and pursuing higher goals. You have the respect of your physicians to help guide, develop and maintain a practice/department and you strive to advance the profession and improve the business of healthcare.

RBMA is the place to turn for inspiration, resources and practical tools you can’t find anywhere else.

Leaders
“The RBMA provides critical information through expertise and dedication to the field of radiology business. Being a member of RBMA as an administrator has provided me with the most up to date information and networking opportunities to assist me in performing at the highest level.”

More Resources For Practice Leaders:

Resources For Leaders

Register now for DataMAXX for reliable and immediate data to make the right operational decisions, optimize resources, continuously improve performance and develop a strategy for the future

X

Welcome, Radiology Business Managers!

As a manager you have come to the right place for information and resources that will assist you in coding properly and obtaining the best possible reimbursement for your practice.

RBMA connects radiology business managers with resources and practical tools to help you succeed.

Manager
“I have been in the radiology business for 34 years and have seen many changes. One of the best changes is how the RBMA has grown and provides us with the necessary tools that we need in order to help us continue on this rocky road.”

More Resources For Managers:

Conference Audio Recording

Articles

Resources For Managers

DataMAXX

RBMA U

Enroll in RBMA U’s Radiology Business 101 – an overview program covering the basics of radiology business as defined under the RBMA Common Body of Knowledge.

DataMAXX

DataMAXX

RBMA’s innovative new practice analytic solution that takes benchmarking to new levels through the combination of your practice’s information and state-of-the art technology and data query protocols.

 

X

Welcome, Coders!

As a coder, you have come to the right place for for information and resources that will assist you in coding properly and obtaining the best possible reimbursement for your practice.

RBMA connects coders with resources and practical tools to help you succeed.

“RBMA membership offerings, either the list serve or conference attendance, has provided up to date trends in coding, payor policy and practice management issues. The topics discussed through the list serve either coding or practice management has helped my practice be proactive.”

More Resources For Practice Coders:

Resources For Coders

Ladies

Prepare for tomorrow. Order your ICD-10-CM Toolkit today.
The IDC-10-CM Toolkit designed by Coding Strategies (CSI) and Radiology Business Management Association (RBMA) gives the busy radiology administrator all of the tools needed to prepare the practice for the implementation of ICD-10.

Libman Education
X

Welcome, Marketers!

As a marketer, you have come to the right place for information on the state of imaging today and how to effectively market your radiology practice by incorporating tools and strategies including social media and today’s technological innovations.

RBMA is the place to turn for inspiration, resources and practical tools you can’t find anywhere else.

“The RBMA Marketing Conference is a great way to network with colleagues from around the country to gain different ideas and perspectives without the threat of direct competition.”

More Resources For Practice Marketers:

Order your Marketing Toolkit today.

A toolkit designed specifically for radiology marketing, includes samples forms and ideas.

Click here to preview Table of Contents.

Resources For Marketers

5 Steps to Effective Social Media Measurement
If you’re going to invest time in social media, you need to measure performance, but it can be difficult to identify relevant metrics.

How to Generate Compelling Content Ideas for Your Online Customer or Member Community [Infographic]
Are you looking for content to fulfill your new content marketing strategy, but don’t know where to start? Try these 10 great content ideas – plus a bonus idea – to jump start or breathe new life into your efforts.

X

Welcome, Vendors!

As a vendor offering radiology products and services you have come to the right place to find your target audience. RBMA attracts decision-makers with buying power.

RBMA members rely on vendors to keep them informed of new technologies, developments, and products for their practices.

“RBMA provides the foundation for connecting with the right people. We appreciate the opportunity to visit with our existing clients as well as meet new prospective clients.”

More Resources For Practice Vendors:

Resources For Vendors

Start planning your 2014 marketing program with RBMA today! Consider a Global Level Sponsorship. Contact daphne.gawronhski@rbma.org for details.

megaphone

Enhance your RBMA presence, increase brand awareness, and solidify your position in the industry through a variety of sponsorship programs

Let's Talk

Vendors Consider How to Approach Hacking Threat in Radiology

(Vendor) Permanent link

Political hacking and cyberwarfare is an ongoing threat, but it is not the only kind. Medical device manufacturers continue to be concerned about the threat of hacking as more and more devices are connected to the internet. Radiology has been a leader in the adoption of the “internet of things,” yet even in this field, the focus has been more on the many benefits derived from connecting systems through the internet and less on the potential dangers posed if devices that communicate with outside systems through the internet are hacked.

At an RSNA 2016 scientific session, researchers from Massachusetts General Hospital presented alarming results from a study of DICOM servers. The researchers used a program to search for DICOM servers worldwide that were unprotected. They found 2,782 unprotected DICOMM servers with 821 of those servers being fully open to outside communication.

What’s worse, in the study, the United States lead the world in number of unprotected servers with 1,150 unprotected DICOM servers. Russia, by comparison, only had 22. Of these, around 300 U.S. DICOM servers could be taken down by a hacker at any time because they were fully open to communication.

While some of the responsibility for the security of medical devices rests with the purchasers of those devices, increasingly equipment manufacturers, installers and servicers recognize that they need to be the leaders here as purchasers (aka, healthcare providers) are rarely in a position to fully understand how advanced devices can be hacked and what they can do to protect them.

In November, the Global Diagnostic Imaging, Healthcare IT & Radiation Therapy Trade Association (DITTA) issued a white paper on cybersecurity of medical imaging equipment. Available through the Medical Imaging Technology Association, the white paper covers many key points, including the following:

  • A critical component of cybersecurity is carrying out security-risk mitigation while the software is developed.
  • Manufacturers should not assume that a secure system today will remain secure tomorrow as hackers are always working on new ways to breach systems. Therefore, manufacturers can and should better define how they plan to continually monitor for security problems that may develop later in the system’s lifecycle and issue fixes and upgrades.
  • Manufacturers and their field service representatives can help educate equipment users on best practices. For example, security whitepapers, issued by manufacturers, are good teaching tools for operators and can help them take steps to reduce hacking risk.
  • When installing a device, suppliers should close unused ports, interfaces and other communication channels on devices. In addition, testing how vulnerable a device is to hacking in the real-world situation it will be used in is important.
Users sometimes hesitate to perform virus scans or install security upgrades because of issues with false positives (saying a device is infected when it is not) and past experiences with upgrades that negatively impacted a device’s functionality. It is important that all upgrades be fully analysed and validated before they are released because once a user has had a bad experience with an upgrade, that user will be less likely to perform upgrades as scheduled in the future.

When it Comes to Stark Law, Good Intentions Don’t Matter

(Marketing) Permanent link

One of the biggest mistakes radiology practice marketers make when it comes to adhering to the requirements of the Stark Law, which prohibits Medicare and Medicaid patient referrals to entities that the referring physician has a financial relationship with, is believing that intentions matter, says Adrienne Dresevic, Esq., founding partner of the Southfied, Mich., firm The Health Law Partners, P.C.

Dresevic and Clinton Mikel, Esq., another partner in the firm, are experts on the many technical requirements of the laws that govern relationships between provider entities and referring physicians. They advise radiology and other specialty groups and have found that while few marketers ever set out to intentionally violate the law, this is of no help when a mistake is made.  

“Stark is a strict liability law so intent doesn’t matter,” Dresevic says. “The law is technical in nature so you can have the best intentions in the world and it really doesn’t matter. All the claims submitted connected with [the violation] are tainted.”

For example, a hypothetical practice might want to help patients who are struggling to cover their co-pays. The practice tells their referring physicians that they are waiving co-pays for Medicare and Medicaid patients. While nice, this is a violation of the law as it would create an incentive for those physician to refer all of their Medicare and Medicaid patients to that practice.

Another common mistake is thinking the law does not apply because there is no financial relationship, but a financial relationship can be triggered by even a small gift, like buying lunch for the physician’s office, if rules are not followed closely, Dresevic says.

Likewise, Independent Diagnostic Testing Facilities that provide mobile imaging services also may think the law does not apply to them because they are not a hospital or physician group, but it does, Mikel says.

Dresevic and Mikel will be presenting on the requirements of the Stark Laws and the Sunshine (Open Payments) Law at the Building Better Radiology Marketing Programs conference in Fort Worth, Texas, on Monday, March 6. Their session will be in a question and answer format and based on a webinar that RBMA members will have the opportunity to watch online ahead of the conference.

Being able to list the key elements of the Stark and Sunshine laws is something everyone on a marketing team needs to be able to do, Mikel says. Although marketers themselves will not be financially penalized by the government if the laws are violated, they need to understand the details of the legal requirements and not leave adherence to the laws up to others in the practice.

“Stark, the Sunshine Act and some of the tracking you need to do for the technical requirements are fairly granular and the persons theoretically overseeing the practice are not the ones doing the day-to-day work,” Mikel says. “They are not doing the day-to-day allocations of how much was spent toward marketing to a particular physician group. These are technical laws and yes the entity will get in trouble if the marketer does not comply with the law, but it is important for the marketer’s job to understand the parameters of dos and don’ts so it doesn’t reach that point of a payment refund.”

In addition, while marketers themselves may not be financially at risk for violating Stark and Sunshine laws, the government can use its exclusion authority to get at a marketer who violates the laws.

To become better at navigating the many legal requirements for marketers in a highly-regulated field like radiology, attend the Building Better Radiology Marketing Programs conference. A special early-bird discount is available until February 3. 


Radiology Groups that Don’t Qualify as Non-Patient-Facing May Need to Work Harder under MIPS

(Coding) Permanent link

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) merged Medicare’s current incentive programs for health care providers into a single quality payment program with two tracks: Advanced Alternative Payment Models (APMs) and the Merit-based Incentive Payment System (MIPS). The track nearly all radiology groups will be on is MIPS.

For MIPS, 15 percent of either a provider or a group’s score comes from a new performance category called Practice Improvement Activities. Examples of such activities include having staff and physicians take the AHRQ survey of patient safety, screening patients for depression, and creating a chronic care/preventive care program.

For the 2017 measurement year (which runs January to October), there are 92 approved Practice Improvement Activities that will earn a practice a certain number of points based on their difficulty. To earn the maximum score, a practice must earn 40 points. Normally, medium difficulty activities earn a practice 10 points and high difficulty activities earn a practice 20 points.

However, CMS recognized that some activities that might be fairly easy for a big primary care group to complete would be much harder for a small, rural or non-patient-facing group to achieve. To create a little more fairness, CMS is allowing these groups to earn double the score for completing activities. For example, instead of a medium-weighted activity earning the practice 10 points, it would now earn the practice 20 points. If the non-patient-facing, small or rural practice is somehow able to complete even one high-weighted activity, it earns 40 points (not 20) and automatically has the highest score possible.  

The potential of double points makes it important for radiology practices to figure out if they will count as non-patient-facing or patient-facing. According to an analysis by the American College of Radiology, most but now all radiology groups will count as non-patient-facing. Could your group be in the minority that counts as patient-facing and therefore ineligible for earning double points on Practice Improvement Activities?

To tell if your group is a non-patient-facing group, you will need to look at the codes you bill. According to CMS, a non-patient-facing clinician is one who bills less than 100 patient-facing encounters based on this list of evaluation and management (E&M) and surgical codes. A non-patient-facing group is one where 75 percent or more of the clinicians in the group are non-patient-facing clinicians. The Neiman Institute has posted a Radiologist Patient Facing Data set on its website to help radiologists look up whether they or their practices would count as non-patient-facing based on what they billed two to four years ago.

The RBMA is following this and many other developments coming out of the implementation of MACRA closely. An overview document for MACRA and MIPS was posted on the RBMA Gateway this month. (RBMA membership required to access.)

To browse the list of 2017 Practice Improvement Activities and select the ones that might make the most sense for your practice to complete, check out the Quality Payment Program website’s Improvement Activities page


Cures Act Creates New Employee Benefit Option for Small Employers

(Management) Permanent link

Before the enactment of the Affordable Care Act, one way small employers who could not afford a health plan could still help their employees get health insurance was to give employees a pre-tax stipend to purchase an individual insurance plan. The ACA made such arrangements illegal. Now this issue has found a fix in the recently-enacted 21st Century Cures Act.

Although the Cures Act is primarily about health and medical research spending, it includes many legislative fixes and one of those is the creation of the Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) in Section 18001 of the law. Essentially, setting up a QSEHRA gives an employer a legal exception to the current law prohibiting employers from paying employees to buy their own individual health insurance.

With a QSEHRA, an employer with 50 or fewer employees who is exempt from ACA coverage requirements and doesn’t offer a group health plan can now offer employees pre-tax dollars to reimburse them for all or part of the cost of purchasing an individual health plan up to a set annual maximum. Employees must furnish proof of insurance and could face tax penalties if they let their individual plan lapse during the year but continue to receive their monthly pre-tax stipend or reimbursement under the QSEHRA benefit. However, as long as employees understand the rules, it can be a helpful benefit for employees and a way to make a small practice without a group health plan a more attractive place to work.

QSEHRA contributions are like other benefits in that they must be fair and offered equally to all employees. An employer cannot give different amounts to people in different roles, like techs and patient service representatives. It also must follow specific procedures for notifying existing and new employees about the benefit and how it will be administered. At least 90 days notice must be given and as it is an annual benefit, it is best to announce it in the fall of the previous year when most health plans hold their open enrollment period

Practices without a group health plan that are interested in possibly creating a QSEHRA benefit should work with their human resources department or consultant, as well as a tax advisor familiar with the requirements of this new legal exception to the prohibition on reimbursing employees for purchasing individual plans. Figuring out how much you will be able to afford to offer each employee is the first step, and this can be a tricky proposition in a rapidly changing health care marketplace where the impact of a potential ACA repeal is still being figured out. It is also important to remember that a QSEHRA is a benefit. It is not a cost-sharing arrangement, so you cannot reduce an employee’s regular salary to give them the QSEHRA benefit even though it might reduce the employee’s income taxes to do so.

In addition to the law itself (linked above), there are blog posts from HR consultants that can be helpful in gaining a better understanding of this new law. Here are three such posts.


15 Attributes of Good Leaders in an Era of Change

(Leadership) Permanent link

“The Times They Are a-Changin’” was written by Bob Dylan in 1963, a year when civil rights and student protests moved the nation. As Dylan was awarded the Nobel Prize for his lyrics as poetry in December, the message he sang more than 50 years ago seemed strangely relevant once more. First up in changes for the nation is health care with a major push for the repeal of the Affordable Care Act in the first 100 days of President Trump’s administration.

Leading through change is never easy, and it is easy to lose sight of the big picture when changes come almost faster than one can manage. The current issue of the RBMA Bulletin magazine focuses on leadership and includes an article by Patrica Kroken, FACMPE, CRA, FRBMA, called “Revenge of the Baby Ducks” that discusses how even experienced managers can lose their cool when “pecked to death by baby ducks.” Kroken describes this as being overwhelmed by issues that individually would not be a big deal but together prove exhausting and sometimes spirit breaking.

However, the issue also includes an inspiring essay by RBMA member Len Shepard, who is the billing director for Phydata, the billing arm of Advanced Diagnostic Imaging, Advanced Health Partners, and Premier Radiology in Nashville, Tenn. Shepard explains how over his many years in management, he has noticed that good results come when leaders exhibit 15 basic traits. These traits are a great reminder of how to be a leader even on days when you may feel more like a Charlie Brown than a George Washington. Here is Shepard’s list:

  • Bold—Set out a bold goal, post it on the wall in front of you, then live it every day.
  • Optimistic—Set out an optimistic goal: “We will be the best billing operation of its kind.”
  • Believe—Once you set that goal, if you don’t believe it, no one else will.
  • Listen—The people who work for you have the answers, not you. You have to engage them, then listen to hear them.
  • MBWA—Do not sit at your desk. You cannot manage by email. The most effective leadership technique in my arsenal has been Management by Walking Around (MBWA).
  • Respect—Be willing to do the most menial job. Even better, do the most menial job, even if it is just once. When you respect the person with the lowest title, you earn your team’s respect.
  • Example—Good leaders breed good leaders: “Watch what I do: If I do it well, practice that. If I do it poorly, do it better when you have the chance.” Good leaders set an example and elevate the performance of the people around them.
  • Steady—Do not react rashly and more importantly, do not over-react. Steady as she goes.
  • Consider—Be mindful of setting precedents: If an exception is made for one situation, consider that there will be another similar situation.
  • Passion—Passion is important. People respect passion when it is properly channeled.
  • Defend—Stand up and defend the people who work for you. Show your passion here if needed.
  • Praise—Praise publicly, correct privately. Never embarrass your staff members in front of others.
  • Remember—Remember who works for whom. The best leaders know that they work for their staff, not the reverse.
  • Strength—Be strong enough to terminate those who don’t fit.
  • Courage—Do what’s right, not necessarily what’s expedient. We earn the right to lead by exhibiting the courage to make hard choices, not easy ones.

For more great perspectives on leadership, read the current issue of the RBMA Bulletin here. (RBMA membership required.)  

Government Steps Up to Help Software Vendors

(Vendor) Permanent link

As health care moves from paying for individual services to paying for value, the need to automate the tracking and reporting of the metrics Medicare and Medicaid will use to determine value becomes increasingly important. Unfortunately, the traditional legislative rule making process with its 30-day comment periods and its very human way of organizing a problem can make it difficult for software vendors to quickly and affordably produce the products needed to automate reporting in time for when the reporting requirement goes into effect.

Software companies need time to plan, build and test new reporting features, and the more users they have for their product, the longer this may take. They also need to know early on the minute specifics of the reporting requirement such as exactly what value will need to be collected and where it will need to go. Current rule making often focuses on the broad objectives first and then slowly works down to the minute details, releasing these as one of the last steps in the process. Finally, programmers need help on the basic software building blocks for new reporting functions so that different groups of programmers from different vendors are not wasting their time each inventing the same wheel.

Fortunately, the Centers for Medicare & Medicaid Services seems to be following the lead of other agencies such as the Consumer Financial Protection Bureau and is starting to release tools vendor companies can then take and customize into innovative reporting tools for the health care market.

In November, CMS released an application program interface (API) for software developers to use when creating electronic data submission tools for participants in either the Advanced Alternative Payment Models (APMs) or Medicare Incentive Payment System (MIPS) created by the Medicare and CHIP Reauthorization Act.  The goal is for this software building block to help both private companies and physician organizations like the American College of Radiology that are involved in submitting quality data to CMS.

CMS has also created a new Medicare Quality Payment Program website  to educate clinicians on how to participate effectively in the Quality Payment Program, as it is hearing from many providers that the current costs of buying the software and investing the time necessary to participate are becoming prohibitive.

The American College of Radiology is among the many organizations that has publicly supported CMS’s release of the API for the Medicare Quality Payment Program. In the press release announcing the API, CMS promised that it would continue to release data and more APIs in the future to aid in technology development. To see the API Swagger documentation, please visit https://qpp.cms.gov/api/

UCSF Marketing Stats Offer Fresh Insights

(Marketing) Permanent link

Marketing a practice begins with knowing your local customers inside and out. However, it can be helpful to observe marketing efforts in other communities, especially in regards to predicting future trends.

In late 2015, Laurel Skurko, marketing director for the at University of California San Francisco Department of Radiology & Biomedical Imaging, began to publicly share results from the department’s surveys of referring physician. Her team recently completed another such survey and the results point to some interesting trends other marketers should be aware of.

  • Email marketing is alive and well. Among the 20 percent of referring physicians in the Bay Area who responded to the survey, 80 percent indicated they preferred email for staying in touch with UCSF Imaging.
  • Electronic newsletters may be particularly helpful. Skurko noted that the percentage of physicians who preferred email had doubled from 40 percent to 80 percent since the department last surveyed referring physicians a little over a year ago. The most likely explanation for such a big jump was that the department had begun to send out a monthly newsletter to the same list of physicians emailed the survey.
  • Social media use is growing, but was still fairly modest for referring physicians. This was true even in tech-industry dominated San Francisco.  Among survey respondents, only 10 percent indicated they used social media as a primary source of professional news. LinkedIn was the number one social media network for professional news and Facebook was number one for personal social media use with half of the respondents saying they used Facebook.
  • Marketing continues to make a big difference. In the survey, the marketing team compared awareness of two different UCSF facilities. One facility had had recent promotion because it had added PET/MRI. The other facility had no recent promotion. The team found that awareness of PET/MRI was 20 percent and the practice receiving the promotion had a 16 percent awareness rating among external physicians. The practice that had not had promotion had only a 7 percent awareness rating.  
  • Word-of-mouth remains incredibly valuable. Roughly a quarter of the physicians who responded to the survey were UCSF doctors in specialties that regularly refer patients for imaging. Among these doctors, awareness of the new PET/MRI service was 48 percent and awareness rating of the facility itself was 25 percent. Skurko attributed these higher levels of awareness by UCSF doctors to the power of word-of-mouth marketing among internal audiences.

 

Additional results and analysis is available on the UCSF blog. For more sharing of ideas that can advance your own radiology practice marketing, make sure to attend the RBMA Building Better Radiology Programs meeting in Fort Worth, Texas, from March 5 to 7, 2017. Register here.  


©2017 Radiology Business Management Association (RBMA). All rights reserved. | RBMA 9990 Fairfax Blvd., Fairfax, VA 22030 888.224.7262 contact us