|
Introduction
Contact Information
Structure
Purpose & Function
Patient Care
Radiology Care
Top Ten Reasons to be an ACR Member
Past Triumphs
Major Recent Accomplishments
& Current Issues |
| Introduction: |
| Why Join
the ACR? The young radiologist just starting practice faces a bewildering array of state
and national medical and radiological societies vying for his/her limited financial
resources/potential dues. Filled with lots of esoteric knowledge and dozens of
differential diagnoses (from studying for the boards), the new radiologist usually has
little experience with the practice of medicine and no idea what individual societies do.
Which ones to chose to join and why? |
| The
established radiologist on the other hand often encounters the same dilemma for different
reasons. Having joined multiple societies in an initial rush of enthusiasm, economic
realities set in and he/she faces the difficult choice of pairing down the number to a
manageable level. Which ones to chose to keep and why? |
For the
New Jersey radiologist, the answers to both questions are the Radiological
Society of New Jersey (RSNJ) and its parent organization, the American College of
Radiology (ACR). Hopefully, the benefits of participating in the RSNJ are apparent from
the material contained on this website. The goals of the RSNJ are to:
- Promote quality radiological services for patients
in New Jersey
- Maintain high ethical standards in the practice of
radiology
- Sponsor continuing education programs for
physicians and technologists, and
- Represent the radiological community with respect
to regulatory, legislative, and socioeconomic health issues that arise in the state
|
| The
purpose of this section therefore is to extol the virtues of membership in the ACR, which
mirrors the efforts of the RSNJ on the national level, and therefore is the single most
important radiological society at the national level. Radiologists should bookmark their
website at www.acr.org and visit this valuable resource
frequently. |
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| Contact Information: |
Radiological Society of
New Jersey
26 Eastmans Road
Parsippany, NJ 07054
973-597-0938 Ext. 105
973-992-6020 FAX
http://www.rsnj.org |
American College of
Radiology:
ACR
1891 Preston White Drive
Reston, Virginia 20191-4397
1-800-ACR-LINE
http://www.acr.org |
| Structure: |
| The ACR is
comprised of 32,000 members including 75% of all board certified radiologists. The college
is run by a staff of over 250 as well as 2,000 volunteers and has an annual budget in
excess of $30 million. A Council of 264 members, 228 of which are elected at the state
level governs the ACR. One councilor and alternate councilor are chosen for each 100
active members. The Board of Chancellors, comprised of up to 25 members, is responsible
for carrying out the actions of the council through different committees and commissions. |
| Purpose & Function: |
| The
American College of Radiology is the primary socio-economic organization for radiologists
and has two fundamental purposes: Patient care and Radiologist Care. |
| I. Patient Care |
| The ACR
has numerous programs, which foster high quality radiological patient-care, including: |
A. Accreditation programs
The ACR has developed 7 accreditation programs
that have been recognized by the federal government for their excellence. The mammography
accreditation program, originally developed in the late 1980's formed the basis of the
federal Mammography Quality Standards Act in 1994.
|
B. Standards
There are currently 95 practice standards
establishing minimum level requirements for various radiographic examinations. These
standards assure that imaging procedures, when performed, are of uniformly high diagnostic
quality.
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C. Appropriateness Criteria
Appropriateness Criteria have been
developed and extensively referenced for a variety of clinical scenarios to insure that
the best test is done to make the diagnosis. This provides important guidance to payers
for cost-effective radiological care.
|
D. Educational Activities
1. ACR Sponsored Symposium
2. ACR Teaching File
3. Texts
4. In-Training examinations
5. 7-Part Video Series on non-clinical skills
|
E. State Chapter Meetings
A complete list of these activities with
topics, dates, times, and locations can be found elsewhere on this site under activities.
|
F. Cancer Treatment Programs such as the National
Cancer Institute sponsored programs:
1. Patterns of Care Study
2. Radiation Therapy Oncology Group (RTOG)
|
| II. Radiologist Care |
| The ACR is
also the primary socio-economic and legal organization for radiology: |
A. Represents radiologists before:
1. Congress & State Legislatures
2. Federal & State Agencies
3. Medicare and Third Party Payers
4. National and Local Media
5. Federal and State Courts
6. Organized medicine
7. CPT-IV and ICD-9 coding committees
8. State Medicare Carrier Advisory Committees
|
B. Publishes numerous materials to keep members
informed - ACR Bulletin
|
C. ACR Website - www.acr.org
|
D. Conducts public relations campaigns to enhance
radiology's public image
|
E. ACR Professional Bureau - job listings
|
F. ACR founded additional political
organizations:
1. Radiology Advocacy Alliance (RAA)
2. Radiology Political Action Committee (RADPAC)
|
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| III.
Radiology Resident Care |
| The ACR
provides numerous benefits for the future radiologist in training: |
A. Automatic Free Membership in the State Chapter
Society and ACR, with a gradual increase in the latter over a four year period
|
B. ACR Standards - 95
|
C. ACR Appropriateness Criteria
|
D. ACR Bulletin
|
E. Annual ACR In-Training Examination
|
F. ACR Video Presentations on Non-clinical Skills
1. Job Search
2. Practical Business Issues
3. ACR Standards, Accreditation Programs, Appropriateness Criteria
4. Critical Thinking Skills
5. Ethics
6. Service Orientation/Interpretation Skills
7. M edical Organization Policies
|
G. Professional Bureau - job listings available
on both state and national levels
|
H. Fellowship Directory - national directory of
radiology fellowships
|
| Top Ten Reasons to be an ACR Member: |
The ACR
has composed the following "top ten list" of reasons radiologists should be
members:
- Leader in Patient Care
- Career Investment
- Reimbursement
- Cancer Treatment
- Image
- Opportunities for Involvement
- Representation
- Support of Tomorrow's Radiologists
- ACR Fellowship
- Member Benefits
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| Past Triumphs: |
Probably
the three greatest socio-economic triumphs of the ACR are:
- The establishment and maintenance of radiologists
as physicians under Medicare Part B
- The development of radiology's own RBRVS (resource
based relative value system) - the only medical society which has done so
- The defeat of self-referral through numerous state
legislations as well as Stark II at the federal level.
|
| Major Recent
Accomplishments and Current Issues: |
| I.
Government Relations Campaign: |
| The ACR
has worked aggressively over the past 2 years to defeat efforts to weaken existing
self-referral laws. Hundreds of letters, phone calls, and/or e-mails have been sent to
Congress to further this effort. On October 3, 2000 Representative Thomas withdrew his
amendment (HR 2651-Physician Self Referral Amendments of 1999), which would have weakened
the Stark II ban against self-referral. This is a very significant victory for radiology. |
| The ACR
supported the initial proposal of managed care reform initiatives that ultimately passed
the US House of Representatives. |
| Reauthorization
for MSQA (Mammography Quality Standards Act) included two provisions supported by the ACR.
The College is currently working actively with Congress to increase reimbursement for
mammography screening under Medicare. |
| The ACR
continues to work with its state chapters to pass telemedicine licensure legislation. To
date, 23 states have passed laws requiring some type of licensure. Other state issues that
the College has promoted include radio logic technologist licensure, medical physicist
licensure, and managed care reforms. The College has also provided assistance with
alternative approaches to Certificate of Need Laws. |
| As part of
the ACR's annual State Chapter Leaders' Meeting, over 140 radiologists, radiation
oncologists, and medical physicists came to Washington this spring to meet with members of
Congress and advocate for radiology. |
| The
College continues to work with HCFA, Congress and the states to educate them on the proper
training necessary for non-physicians performing diagnostic x-ray services. |
| The
Radiology Advocacy Alliance (RAA) formed a non-partisan federal political action committee
(RADPAC) in 1999 to support "radiology friendly", federal candidates. To date,
RADPAC has raised in excess of $240,000. |
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| II.
Public Relations Campaigns |
| The ACR
launched a PR initiative in 1999 to further enhance the public image of the radiologist
and to highlight the cost-effective use of quality radiology for patients and managed care
organizations alike. Ads have run in newspapers (New York Times, Wall Street Journal,
etc.) and magazines (e.g. Ladies Home Journal) while staff exhibited at national health
insurance meetings to promote radiology and ACR programs. |
| On October
15, 1999 over 2,200 ACR-accredited facilities participated in National Mammography Day,
which provides discounted or free mammograms to women throughout the United States. The
ACR serves as the facilitator for National Mammography Day. |
| The ACR
reorganized and relocated its extensive archives this past year. The archives are now
housed at the History Factory in Virginia. The reorganization of the materials will
provide greater access and convenience to those seeking to learn more about the history of
radiology. |
| III.
Accreditation Standards, and Appropriateness Criteria |
| The JCAHO
recognized ACR's Radiation Oncology Program as meeting its own standards. Currently, ACR
programs in mammography, MRI, ultrasound, breast biopsy, and nuclear medicine are under
similar review. Six state governments, Medicare carriers for 9 states and D.C., and at
least six private third party payers have now recognized ACR accreditation as a
requirement for qualitative or reimbursement purposes. |
| The ACR
continued its focus on quality imaging with the development of five new standards,
including a collaborative effort with the American Society of Neuroradiology, the Society
of Cardiovascular and Interventional Radiology, and the American Society of Interventional
and Therapeutic Neuroradiology to produce a comprehensive standard on Cervicocerebral
Neuroangiography in Adults. In addition, twenty-two existing standards were reviewed and
updated. During the 2000 ACR Council Meeting, the ACR Council considered 13 new standards
and revised 18 existing standards. |
| The ACR
continues to revise and expand Appropriateness Criteria and a total update will be
completed by the end of this year. Portions of the work of the Expert Panel on Radiation
Oncology have been published in the International Journal of Radiation
Oncology-Biology-Physics. Supplements to Radiology have been published both as an overview
article on topics developed by the Task Force as well as a printing of a completely
updated version of the criteria. |
| There has
been an increasing recognition of BI-RADSTM and the National Mammography Database for
reporting in the national and international imaging community by requests to use the
trademark and to include BI-RADSTM in various products. Efforts are continuing to create a
complete atlas for breast imaging reporting by expanding the lexicon to include ultrasound
and MRI. The National Mammography Database anticipates a major launching effort by the end
of the year. |
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| IV.
Economics |
| The ACR
has commented extensively on the new Hospital Outpatient Prospective Payment System
(HOPPS) and its relative weights known as Ambulatory Payment Classifications (APCs)
effective August 1, 2000. The ACR will continue to monitor the groupings of radiology
procedures into APCs and the values assigned for the technical component of outpatient
procedures. |
| In
addition, the ACR commented extensively on the new "units of service" edits
implemented by HCFA on July 1, 2000. These edits limit the frequency by which any
radiology or radiation oncology procedure may be coded for a patient in one day even with
the use of a modifier. |
| The ACR
Practice Expense Committee was formed with representatives from each of the subspecialty
economic committees. This committee will formalize a mechanism for making recommendations
through collection and evaluation of expense data and the comparison of that data to the
existing Clinical Practice Expert Panel (CPEP) data. |
| The ACR
met with HCFA personnel to request their assistance in clarifying the "ordering of
diagnostic tests rule" (HCFA regulation 410.23) and the "ICD-9 coding
guidelines". HCFA has agreed to formalize, in writing, the intent and interpretation
of the regulation to eliminate any ambiguity. |
| The CPT
Editorial Panel accepted the addition of 26 new and the revision of 58 existing CPT codes
as proposed by the ACR at its February 2000 meeting in Chicago. |
| As part of
the CPT V Project, the ACR CPT Advisor and the Coding & Nomenclature Committee have
reviewed and made recommendations for editorial revision to CPT to further standardize and
enhance the CPT descriptors. |
| In
addition to the standard RUC (Relative Value Update Committee) cycle, the ACR is working
on the second congressionally mandated "Five Year Review" of all CPT codes. This
review is limited to reassessment of the physician work value component. |
| The ACR's
CAC (Carrier Advisory Committee) Network is made up of approximately 200 radiology and
radiation oncology volunteers who spend countless hours attending Medicare Carrier
Advisory Committee meetings, drafting and commenting on radiology and radiation oncology
policies. These policies, known as local medical review policies (LMRP), affect
radiologists' and radiation oncologists' reimbursement for procedures at the state level.
The unique relationships that the ACR CAC representatives have with their Carrier Medical
Directors (CMDs) have been successful in negotiating fair reimbursement policy at the
local level as well as acceptance of ACR accreditation programs in many of these policies. |
| ACR staff
has confirmed all 50 liaison nominations to the Managed Care Network. The Network will
determine needs to effectively deal with Managed Care Organizations (MCO) utilizing the
newly created on-line forum. |
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| V.
Resident Support |
| To further
support the transition of residents into practice the ACR and APDR began the development
of a 7-part video series. The videos focus on non-clinical skills development and practice
issues. The first six videos have been sent to all program directors and ACR chapters. |
| The annual
ACR In-Training Examinations (Diagnostic and Radiation Oncology) are intended to improve
insight into the overall effectiveness of the resident in-training program, both to the
participating resident and the program director. The Diagnostic examination is held in
February and the Radiation Oncology examination is in March. Starting January 1, 2000, the
College drastically reduced its member fees for members transitioning from training to
practice. |
| VI.
Education: |
| The ACR
Education Department, under the direction of the Commission on Education, awards CME
credits through a broad array of educational symposia and products (available in print,
video, and CD-ROM formats). Included among these are the National Conference on Breast
Cancer, the recently developed Cardiovascular Imaging Conferences, and the ACR Mammography
Symposium. Also offered are self-evaluation programs such as the Mammography Interpretive
Skill Assessment Examination and the Continual Professional Improvement (CPI) subscription
series. A new feature launched in the July 1999 issue of the ACR Bulletin is the
"Knowledge Challenge", aimed at enhancing knowledge and skill areas concerning
complex cases in radiology. The Education Department also grants CME credit for jointly
sponsored and co-sponsored radiology educational activities with other academic
institutions. |
| VII.
Research: |
| The ACR
initiated ACRIN, the American College of Radiology Imaging Network, the first standing
collaborative clinical trials group in diagnostic radiology. ACRIN will permit more rapid
and extensive conduct of high quality, multi-center clinical trials than has previously
been possible. Nine protocols are in various stages of development. |
| TASAP, a
program to enhance clinical research by providing to individual investigators without
charge assistance they require in statistical analysis, data management, and study design
for important research studies, was initiated. |
| As part of
the ACR's mission of providing information important to the profession, in the last year
the research staff published 10 major papers in leading diagnostic radiology and radiation
oncology journals. |
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A study of
radiologists' workload measured in RVUs was completed and published in Radiology.
Its data answers the question the ACR research department is most frequently asked,
"What is the workload of a radiologist?" A study of practice costs in diagnostic
radiology practices will appear shortly in Radiology; a similar study of radiation
oncology practices has been completed and submitted to for publication. |
| In
response to growing legislative activity related to self-referral, the ACR stepped up
research activity in this field. The past year saw ACR involvement in multiple
self-referral research studies. Three were published in AJR or Radiology and several
others are scheduled for presentation at RSNA in 2000. |
| The ACR
conducted a large-scale survey of radiology practices in 1999 designed to address issues
of importance to the profession. Data analysis and publications of results are underway. |
| The ACR
completed a study of the use throughout the American health care system of quantitative
standards for procedure volumes and the sources of these standards. Results are used to
guide ACR's standard-setting processes. |
| The future
of radiology rests with those willing to make an investment. Invest in the ACR. It will be
one of the wisest decisions you will ever make. |
