A possible solution to the vexing question of how radiologists will get paid under a new federal compensation system was rolled out this week at the annual American College of Radiology (ACR) meeting in Washington, DC.
The Breast Screening Bundle Tool (BSBT) was presented by the Harvey L. Neiman Health Policy Institute at the ACR meeting.
A solution to the looming CMS payment change to physicians — known as merit incentive payment system (MIPS) — has been especially challenging
"This system rolls out tools that find a robust and fair way for radiologists to adjust to MACRA [legislation that authorized MIPS]," Danny Hughes, Ph.D., Neiman Institute senior director for health policy and research and senior research fellow, told HCB News. " Radiology-driven Advanced Payment Models (APM), such as our proposed breast screening bundle, may allow radiologists to qualify under an alternative payment model rather than wrestling with the complexities of MIPS."
The BSBT allows radiology practices to estimate professional, technical, and global bundled prices for breast screening bundles. This data can be adjusted with different assumptions of which services are included, service utilization and reimbursement rates.
"Physicians must have at least 20 percent of their CMS compensation tied to an APM model to qualify," said Hughes. "This tool should help large radiology and multi-specialty practices meet that standard."
According to Hughes, a work group of the ACR is also developing an APM to assist radiologists, so soon there should be two options that radiology groups can consider to be successful under MACRA. He also said that he believes the breast cancer screening tool can eventually serve as a model for other types of cancer screening bundles.
The launch of the tool follows the publication of a Journal of the American College of Radiology
paper in January, according to Hughes, which found that breast cancer screening provides a framework for radiologist-led bundled payment models. It can be implemented with different services included in the bundle, depending upon a practice's specific patient panel.
The tool was developed using carrier claims data from the Centers for Medicare and Medicaid Services (CMS) five percent Research Identifiable Files from 2013-2015, the most recent years available.