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

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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

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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.

 

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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

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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
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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.

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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.

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What to Know About the New Overtime Rules

(Management) Permanent link
The final rule covering new overtime protections for employees is now published in the Federal Register. The rule will go into effect on December 1 of this year, which gives practice managers some time to assess to which employees the new rules may apply and estimate the budgetary impact of the new rules.

Traditionally, radiology practice clinical staff have been hourly employees with overtime protections. In addition, radiologists, whether shareholders or employees, generally earn above even the new cap of a salary of $913 per week ($47,476 annually) for full-time work to qualify for overtime protection. However, salaried administrative, billing and customer service professionals in a practice may very well fall under the new rule depending on how much they currently earn.

A good first step is to get a handle on exactly how many hours these employees currently work. Flexible policies that allow employees to work from home or remotely can complicate measuring. Employees often appreciate the ability to catch up on answering emails after hours or finish a big project from home. However, this means that they may be working more hours than you may realize.

Ensure you and your affected executive, administrative or professional employees understand the full requirements of the new rule and work together to address how you will measure hours worked fairly and accurately.
The key provisions of the new rule are:
  • White collar workers who earn $913 per week or less for full time work are no longer exempt salaried employees and must be paid overtime if they work more than 40 hours in a week. (The previous cap was $455 per week.)
  • Salaried employees who do not meet the legal criteria for an executive, administrative or professional employee (i.e., they are not a white collar worker) must be paid overtime if unless their salary is the annual equivalent of the 90th percentile of full-time salaried workers nationally ($134,004). Only these “highly-compensated” workers remain exempt.
  • You can use nondiscretionary bonuses and incentive payments (including commissions) to satisfy the new salary level if an employee earns just under $913 per week. However, this cannot be more than 10 percent of the new standard salary level.
  • Going forward, the salary threshold levels for an overtime exemption will be updated every three years starting in 2020.

If you have an employee that regularly works more than 40 hours per week, you have a few options.

  • pay the overtime
  • spread the work to other employees
  • hire part-time help as needed
  • raise the employee’s salary to make him or her exempt from overtime
  • lower the base salary of the employee to take anticipated overtime into account
The last option, while not in the spirit of the law, is not illegal. However, lowering base salary is rarely a practical option for an employer.

The U.S. Department of Labor has published a comprehensive guide (PDF file) to the overtime final rule for private employers. Read it here.

ICD-10 Coding Fix for Cancer Screening of Current Smokers Effective July 5

(Coding) Permanent link
New coverage decisions certainly come with some growing pains. The addition of Medicare coverage for low-dose CT lung cancer screening is a perfect example. Torn between the conflicting desires to both expand access to the only test recommended for detecting lung cancer early in current and former heavy smokers and ensure only reputable high-quality providers offer the test, the Centers for Medicare and Medicaid Services created policies and instructions that were at times confusing.

One area of confusion should be cleared up on July 5, however. That is the implementation date of five International Classification of Diseases Tenth Edition (ICD-10) diagnosis codes for LDCT lung cancer screening in current smokers. Previously, CMS had instructed providers to just use the ICD-10 personal history code ICD-10 Z87.891 (personal history of nicotine dependence). However, personal history codes are not meant to represent a current state and that created a problem for getting some scans of current smokers paid.

Starting with procedures with dates of service of July 1 or later, the Medicare administrative contracts (MACs) should add these five ICD-10 diagnostic codes for current smoker who had a Medicare-covered LDCT lung cancer screening test.
  • F17.210 Nicotine dependence, cigarettes, uncomplicated 
  • F17.211 Nicotine dependence, cigarettes, in remission 
  • F17.213 Nicotine dependence, cigarettes, with withdrawal 
  • F17.218 Nicotine dependence, cigarettes, with other nicotine-induced disorders 
  • F17.219 Nicotine dependence, cigarettes, with unspecified nicotine-induced disorders
According to the ACR, it has received assurance that providers whose claims were held up by this issue for so long that the claim is now past filing deadlines, can still file the claim and be paid for it. They should not need to write it off because this was CMS’s oversight.

In addition, the ACR recently set up an email specifically for lung cancer screening coverage and payment issues. It is LCScoverage@acr.org. Its Lung Cancer Screening Resources page is at: http://www.acr.org/Quality-Safety/Resources/Lung-Imaging-Resources

What issues have you encountered with getting claims for LDCT lung cancer screening tests paid? Please comment below.

Don’t Ignore State Legislative Issues

(Leadership) Permanent link
As federal legislation has become more difficult to pass in recent years, more states are taking matters into their own hands when it comes to health care policy. This makes what is happening at the state level just as important for radiology leaders to stay on top of as what is happening at the federal level.

Consider that in the past month, we have seen:
  • A very strong and united effort by Hawaii radiologists to add clinical decision support to a bill to set prior authorization standards for all health insurers in the state fail to pass.
  • 3D mammography added as a required benefit for insurance companies operating in Connecticut.
  • Florida passing a new law exempting patients from having to pay balance bills from out-of-network providers in certain situations, including potentially if an out-of-network radiologists reads images for a PPO patient.
To help radiology leaders be informed about what is happening within their states and gain access to the right resources for advocating for or against policy proposals at the state level, the RBMA has created a members-only list serve forum for state legislation. Sign up by going to http://www.rbma.org/RBMA_Forums/.

In addition, the RBMA Washington Insider e-newsletter tracks both state and national legislative issues. The most recent issue is always available for free to anyone who visits http://www.rbma.org/RBMA_Washington_Insider/. Previous issues are available to RBMA members who are logged in on the RBMA website.

Healing the Marketing-Finance Relationship

(Marketing) Permanent link
According to a 2015 report by EY — the assurance, tax, transaction and advisory services company that includes Ernst & Young — only 43 percent of C-suite executives they surveyed felt there was a strong bond between the CMO and the CFO, compared with 60 percent who felt there was a strong CMO-CEO bond.

For experienced radiology marketers, this will not be surprising. There is a traditional tension between finance, which is tasked with holding down costs, and marketing, which is tasked with increasing revenue by spending money to attract more referring physicians and patients.

However, finance and marketing are both part of operations and radiology practices work best when the two are aligned. When they are not, it can spell big trouble.

In the new governance issue of the RBMA Bulletin, Kim Kelley, FRBMA, principal and creative director of Ali`i Marketing & Design, discusses what to do when there is practice leadership change that impacts the marketing plan.

“If you have a strong board or executive committee that backs the marketing function, then you are in good hands,” she writes. “But when there is a turnover in leadership and cost-cutting is a constant, marketing can lose that support, and oftentimes the necessary funding to carry out best laid plans. In this situation, marketing may find itself under extra pressure to sell their continued worth to stakeholders.”

The good news is that there have never been more ways to measure the impact of marketing. From social media “likes” and “shares” to website page views and link clicks, there is an abundance of ways to quantify marketing results. The bad news is that unless you and your practice leadership work together to select the right key performance indicators (KPIs), then you could end up chasing metrics that do not matter and ignoring those that do.

The best KPIs are those that relate directly to your end objective. A great example of the right KPIs in action comes from this year’s Quest Award winner in cause-related marketing with budgets under $5,000. Jefferson Radiology partnered with local Hartford, Connecticut, CBS affiliate WFSB on a series of video public service announcements for the 2015 Breast Cancer Awareness month. They tracked WFSB viewership data for the times the PSA was aired and compared the number of views for Jefferson Radiology’s YouTube channel to the same time the previous year. However, the ultimate KPI was number of scheduled mammogram appointments during the month. The practice needed 22 more mammograms scheduled during the month to break even on the campaign. They easily exceeded that as there were more than 6,000 mammogram scheduled throughout the run of the partnership and into November. Now what CFO wouldn’t love that!

Is it safe to relax on ICD-10?

(Vendor) Permanent link
Considering the industry-wide concern ahead of the October 1, 2015 implementation of the International Classification of Disease, Tenth Edition (ICD-10) coding standards, the transition seems to have gone relatively smoothly. Generally, the worst case scenarios - interruptions in practice cash flow and negative impact on coder productivity - did not happen, which is great news to hear.

In late April and early May, Merge Healthcare, an IBM Company and a leading provider of medical imaging solutions, interoperability and clinical systems, surveyed its customers on their experiences six months into the switch to ICD-10. Almost all customers who responded to the survey had their own staff certified ICD-10 coders. They reported similar coder productivity on ICD-9 and ICD-10. In addition, no respondents said that they had noticed an increase in specific claim denials so far.

“It is encouraging to see that the switch to ICD-10 went relatively smoothly for our customers,” says Shannon Marshall, solutions manager for radiology workflow at Merge. “The solutions we’ve developed for the radiology market are designed to be vendor neutral and flexible. Tools like our auto-coding feature can be helpful as coders gain experience with ICD-10. In addition, solutions such as Merge Financials™ and Merge Dashboards™ also gather valuable data and present it in an actionable format so that our customers can better manage all aspects of their businesses, including claims. For example, the solutions can help quickly detect an uptick in certain denials so that our customers can do a root cause analysis and fix the problem before it has a more major impact on practice financials.”

Still, ICD-10 is an evolving situation. Keep in mind that after October 1, 2016 (12 months post-ICD-10 implementation), Medicare review contractors will begin to deny claims with an incorrect level of ICD-10 specificity. As Medicare administrative contractors, the recovery audit contractors, the zone program integrity contractors, and the supplemental medical review contractors begin to flag claims without the appropriate level of specificity, denials may very well begin to creep up.

“It is important to have tools in place that allow you to monitor all aspects of practice performance, especially denial tracking for claims,” Marshall says.

The Merge solutions work together to track denials with customizable reports and work queues, she explains. In addition, these work queues can be customized to allow specific types of denials to go to the appropriate staff for review and resolution. The result? A practice that can quickly build up internal experts on certain denials types and maintain visibility into its operations for better payment assurance. Having a deeper understanding of your process and maintaining constant touchpoints within your workflow are imperative to navigate your practice forward during changing tides.

“For example, not only can you route a specific subset of denials to one person, but you can have that same person work with the Medicare denials for that subset of codes while another person does follow up for the commercial payers for those codes,” Marshall explains.

And because Merge’s financial and dashboard tools integrate with its other solutions for RIS, PACS, scheduling, referrals and more, the solution packaging can be customizable and scalable for a practice’s exact needs. To learn more about Merge solutions, visit http://www.merge.com/Solutions/Radiology.aspx.

RBMA Radiology Summit Day 3: Beyond Forecasting and Predicting

(Radiology Summit) Permanent link
The third and final day of the Radiology Summit in Colorado Springs, Colorado, dawned with brilliant sunshine and a crispness in the air, as if designed to focus the thinking of the attendees on what may come next. Helping them get a new perspective on what the future may bring for radiology was opening speaker Seena Sharp, author and principal of one of America's first competitive intelligence firms, in her Radiology Summit presentation.

“Forecasting and predicting was what we were taught to do, but you can only measure things that have happened,” she said. “That means, forecasting is either based on the past or it is based on estimating and guessing what would happen. I want to shift thinking from forecasting and predicting to unfolding. Unfolding means that it is already happening, but it is under the radar.”

To do this, Sharp encouraged attendees to look outside the field of radiology, and even the field of health care, to discover trends and spot new ideas that could either be borrowed or adapted to either solve current problems or discover whole new markets.

“If you are an industry where there is an aspect of your business that has not changed much that is a clue that this is an area that is ripe for opportunity,” she noted.

Where are the opportunities in radiology? Sharp stayed for a second session explaining millennials, a market still very new to radiology but which she predicted would, like the baby boomers, have a tremendous impact on society and business for decades to come. At other concurrent sessions, attendees also learned about Strategic and Tactical Practice Management and considered the pros and cons of outsourcing IT. Meanwhile, hospital-based practices huddled in their dedicated roundtable session to discuss burning issues, like the increase in ICD-10 denials, the new Joint Commission requirements to furnish individual radiologist performance data, and the ongoing challenge of collecting money from patients as they become increasingly responsible for a larger share of their cost of care. As the final Radiology Summit drew to a close, the forecasted rain in Colorado Springs continued to hold off. Yes, Sharp was right. You can’t always go by forecasts.

RBMA Radiology Summit Day 2: Building Leaders

(Radiology Summit) Permanent link
Are great leaders born or are they made?

As radiology business owners and managers are increasingly asked to become leaders in a rapidly changing health care environment, this is an important question. Alexander Norbash, M.D., M.S., FACR, chair of radiology at the University of California, San Diego School of Medicine, offered his expert analysis of the literature on leadership, what can be learned from the lives of historical figures known for their leadership skills and his own personal experience as a leader in radiology.

“People who become very good leaders do not necessarily live extraordinary lives,” Dr. Norbash explained in his general session on the second day of the RBMA Radiology Summit in Colorado Springs, Colorado.

In other words, some leaders are born, but most are made — and that is great news for anyone who wants to learn to be a better leader.

Carol Hamilton, MBA, SPHR, FACMPE, a practice administrator for West County Radiological Group, in St. Louis, Missouri, was one of the people in the audience at Dr. Norbash’s session, and she found his tips for becoming an effective leader to be one of the most helpful part of the conference. She plans to use some of the tools he presented to rally her team around the many business challenges radiology business now face.

Many of those challenges were the focus of RBMA educational sessions on the second day of the Radiology Summit. For example, the RBMA’s Mike Mabry once again teamed up with RADPAC’s Ted Burnes to present the Radiology Economics and RADPAC Update to a packed room eager to hear about what may happen with reimbursement changes, clinical decision support, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), and the congressional elections. According to Burnes, there are several legislators that have been allies to radiology that are facing challenging races, including Sen. Kelly Ayotte (R-N.H.) who has been a strong supporter on mammography issues of concern to the American College of Radiology (ACR) and RBMA.

In another session, Bob Bell, Ph.D., and Kevin McDermott, MHSA, of AIM Specialty Health addressed how to integrate radiology quality measures into the move toward greater transparency in health care. If radiology is to be judged on its quality and value, getting the measures right is key.

Perhaps most instructive of all, longtime radiology payment advocates Robert Barr, M.D., FACR, and Joshua Hirsch, M.D., FACR, (with a little help from the ACR’s Pam Kassing, FRBMA, in the audience) spent an hour breaking down in detail the history of payment methodologies in radiology and what may lie ahead for radiology business as the Medicare Incentive Payment System (MIPS) and Alternative Payment Methodologies (APMs) take hold. It is a critically important subject because radiology touches the work of nearly all other specialties of medicine, and as those specialties figure out how to shift to a value-based world, their decisions will impact radiology as well

“What scares me the most is radiology being on the side while others figure out alternative payment models that pull us in,” Hirsch said.

There is no single solution to all the challenges facing radiology. However, the industry can act to improve its future, speakers noted, by focusing on advocacy, staying informed and educated, and perhaps most important of all, learning from each other at events such as the RBMA Innovation Learning Lab held that afternoon.


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