Radiology Digest – July 11, 2023

July 7, 2023

Radiology Digest: News from the week of July 11, 2023.
American Medical Association Issues CPT Code for AI-based Brain MRI Software

By Marty Stempniak | July 6, 2023 | Included in Radiology Digest – July 11, 2023

The American Medical Association has issued a new CPT code for an artificial intelligence-based brain MRI software tool, the product’s developer announced recently.

Icometrix said the current procedural terminology code covers its FDA-cleared quantification software, “creating a path to reimbursement.” The program works by assisting physicians with diagnosing, monitoring and assessing treatment options for brain disorders such as multiple sclerosis, Alzheimer’s, dementia, epilepsy, stroke and traumatic brain injury.

To date, only three companies in the fields of cardiac care, lung cancer and liver disease have been able to earn category 3 CPT codes in radiology, the company noted.
“This is a major milestone for Icometrix, for the radiology and neurology communities, and most of all for patients living with neurological conditions,” CEO and Founder Wim Van Hecke, PhD, said in a July 1 announcement.

Medicare, Medicaid and commercial plans use such CPT codes to identify procedures and services. After the code takes effect, Belgium-based Icometrix noted, imaging centers and hospitals can use it to submit claims for AI-based analysis of MRIs.
The AMA decision comes as experts anticipate that imaging volumes will continue to climb in the coming years.

“Shifting demographics and aging populations are key drivers increasing the demand for brain MRI procedures, and for developing and measuring biomarkers to assess and manage the growing burden of neurologic diseases,” John E. Jordan, MD, chair of the American College of Radiology Commission on Neuroradiology, said in the announcement. “Neuroimaging can be a tedious and extremely challenging task for radiologists, particularly as clinical burdens and disease complexity continue to increase.”

To read more, go to Radiology Business.

New ‘Second Opinion Platform’ Allows Patients to Question Their Radiologist’ Findings

By Marty Stempniak | July 6, 2023 | Included in Radiology Digest – July 11, 2023

A South Florida vendor has launched a new “second opinion platform” allowing patients to tap outside experts to question their radiologist’s findings.

MDView said the service lets individuals securely upload medical image files and records. They then can match up with independent, subspecialized physicians who review the information. Patients are able to pick their preferred radiologist, with the option to also add a video consultation, the Cooper City, Florida-based company said Wednesday.

“Getting a second opinion should not be so difficult and it certainly should not take weeks or months, especially when faced with any condition that requires immediate action,” CEO and Co-founder Tracy Amato said July 5. “Our mission at MDView is to simplify and drastically shorten the process of getting a second opinion, and we are starting by giving access to fast and affordable radiology second opinions.”

Doctors working for MDView have access to a standard DICOM and medical record viewer within the tech company’s prioritized work list. The vendor said it contracts with outside teleradiology groups such as Transparent Imaging, which reads about 500,000 exams annually, to provide the service.  

“The importance of a second opinion read on diagnostic imaging is well-documented but not readily accessible to patients who want a radiologist to take a second look,” Eric Ledermann, DO, MBA, co-founder of the Lakewood, New Jersey-based teleradiology group, said in the announcement. “MDView empowers patients by offering the opportunity to get a fast second opinion on their radiology images from the comfort of home,” he added later.

The company is urging patients to sign up for a free account on its website. MDView’s service is currently available in Florida with plans to eventually launch throughout the United States. Leaders also are seeking additional radiologists to provide second opinions.

To read more, go to Radiology Business.

Medicare Advantage Profits Could Be Under Pressure in 2024, Analysts Say

By Rylee Wilson | July 5, 2023 | Included in Radiology Digest – July 11, 2023

Medicare Advantage profits will likely be stable in 2023 but could face pressure from rising utilization rates in 2024, according to commentary from AM Best published June 30. 

UnitedHealthcare and Humana, the two largest Medicare Advantage insurers, recently warned of rising medical utilization rates as beneficiaries access care delayed during the COVID-19 pandemic. 

These trends could be widespread across the U.S., with some variation by state, Jason Hopper, associate director of AM Best said in a June 30 news release. 

“MA expenses related to hospital and medical benefits, other professional services, emergency room visits, and prescription drugs have all increased by double digits in the last two years, exceeding premium growth in 2021 and dampening profitability,” Mr. Hopper said. 

UnitedHealthcare and Humana did not change their earnings guidance based on rising utilization, but both companies expected medical loss ratios to fall at the high end of their estimated ranges. 

“Given the growing share of MA earnings in the overall industry’s balance, a deterioration in MA profitability would negatively impact overall industry results,” Sally Rosen, senior director of AM Best said in the news release. “AM Best believes that the health insurance industry and the MA segment will remain profitable in 2023, although 2024 profitability may be pressured.”

To read more, go to Becker’s Payer Issues.

Emergency Radiologists Face Systematic Disadvantages In Current Promotion System

By Marty Stempniak | July 3, 2023 | Included in Radiology Digest – July 11, 2023

Emergency radiologists appear to face systematic disadvantages in the academic field’s current promotion system, according to a new analysis published Friday in JACR [1].
When matched up by gender and career length, nonemergency radiologists are nearly twice as likely to be promoted to associate professor compared to their colleagues working with the ED. Overall scholarly productivity also is lower among emergency radiologists versus other subspecialties, researchers reported.

The findings were derived from an analysis of data spanning 283 emergency radiology faculty working across 25 institutions in the U.S. Researchers note that their conclusions hold significant importance, as emergency departments grapple with growing caseloads and challenges hiring physicians to meet demand.

“These findings raise concern that current academic infrastructure may be structurally disadvantaging the career development of emergency radiologists, which has longer term implications for recruitment, staffing and pipeline development,” Farid Hajibonabi, MD, with the Emory University School of Medicine in Atlanta, and co-authors wrote June 30. “This issue may extend to other nonstandard subspecialties like community radiology,” they added later.

For the study, researchers identified departments containing emergency radiology divisions via three lists. Those included Doximity’s top 20 imaging programs, the National Institutes of Health’s list of top radiology departments, and all institutions offering emergency radiology fellowships. They then identified individual emergency radiologists by reviewing departmental websites and matched them with colleagues of the same gender, at the same institution and with the same career length.

Out of nearly 300 physicians who met the study criteria, researchers were able to pair 112 with similar co-workers for comparison. Hajibonabi et al. unearthed significant differences. Emergency radiologists published a median of three articles versus 26 in the comparison group. They also identified only five full professors in emergency radiology compared to 18 in the nonemergency cohort.

The authors highlighted several possible reasons why ED rads lag behind other subspecialties. Oftentimes, their schedules are designed to prioritize clinical work over education and research, “potentially misaligning career incentives.” Plus, when forced to work odd hours, emergency radiologists may miss key departmental functions, including meetings and “other collaborative activities.”

To read more, go to Radiology Business.

Payers Should Expect a 7% Increase in Healthcare Costs Next Year PwC

By Frank Diamond | June 30, 2023 | Included in Radiology Digest – July 11, 2023

Healthcare costs will balloon 7% next year, as payers hammer out new contracts with providers, the labor shortage stretches on and drug prices continue to increase, according to a new report by PwC.

This represents a jump from PwC cost increase estimates in 2022 (5.5%) and 2023 (6%)
Researchers with PwC’s Health Research Institute spoke to insurance actuaries who work with health plans that cover over 100 million enrollees in employer-sponsored health plans and about 10 million individuals in plans on the Affordable Care Act marketplace.

However, the estimate is not set in stone, as the report said PwC adjusted its medical cost projection for the group market from 6.5% to 5.5% for 2022 due to fewer individuals receiving inpatient hospital care, as they opted instead to get care from outpatient sites.

“The higher medical cost trend in 2024 reflects health plans’ modeling for inflationary unit cost impacts from their contracted healthcare providers, as well as persistent double-digit pharmacy trends driven by specialty drugs and the increasing use of the GLP-1 agonists for Type 2 diabetes or weight loss,” the report said.

Health plans expect hospitals and physicians to seek not only rate increases but also shorter gaps between new contracts. Physician burnout and greater demand for surgeries and procedures post-COVID will also add to inflationary pressures, according to the report.

To read more, go to Fierce Healthcare.

ACR, Members of Congress Agree: ‘Great Urgency’ Needed to Reform MACRA

By Marty Stempniak | June 30, 2023 | Included in Radiology Digest – July 11, 2023

The American College of Radiology and members of Congress are expressing “great urgency” around the need to reform how physicians are being rewarded for delivering value-based care.

Physician Reps. Larry Bucshon, MD, R-Ind., and Ami Bera, MD, D-Calif., are currently circulating a letter to colleagues asking for additional support. They’re concerned about the 2015 Medicare Access and CHIP Reauthorization Act, or MACRA, enacted to begin paying physicians for quality, value and results, rather than the volume of services delivered.

The ACR has joined the two lawmakers, urging radiologists to ask their local representatives to sign the letter, addressed to House leaders Kevin McCarthy, R-Calif., and Hakeem Jefferies, D-N.Y.

“Unfortunately, logistical challenges have plagued MACRA almost since its inception,” Bucshon and Bera wrote in their draft letter, dated June 21. “Incentive payments to encourage Medicare providers to participate in Advanced [Alternative Payment Models] are temporary, and underutilized. Furthermore, the thresholds to qualify for APM incentives and future payment adjustments are at risk of steep increases under current law. Together, these factors could result in fewer providers participating in value-based care models in the years to come.”

ACR issued its “call to action” on Thursday, June 29, noting that MACRA has been “plagued with challenges since its inception in 2015.” The letter comes after physicians and other stakeholders raised concerns about MACRA in response to a request for information from Bera and Bucshon.

“As the nation’s healthcare system faces financial uncertainty, it is now more important than ever to reform the Medicare payment system,” the Radiology Advocacy Network said in its call to action, asking lawmakers to sign the letter. “You are well aware of the challenges facing physician practices and the yearly cuts to physician reimbursement that exacerbate these factors. We need you to take action now to ensure Congress addresses these issues.”

To read more, go to Radiology Business.

Is It Time for Radiologists to Head Back to the Reading Room? New Data Reveal Trends in Remote Radiology

By Hannah Murphy | June 29, 2023 | Included in Radiology Digest – July 11, 2023

Three years after the height of COVID forced a global transition to remote work, many professionals are now being called back into the office, including radiologists. 

A new paper in the Journal of the American College of Radiology that details recent trends in both remote and in-person radiology settings indicates that teleradiology is likely here to stay—at least for some. Based on survey responses from 345 members of the American College of Radiology, academic radiologists are disproportionately being asked to return to the reading room in comparison to their peers. 

Prior to COVID, just over half of those surveyed reported that their organization enabled providers to read remotely (53%); that figure increased to 91% during the pandemic. In non-academic settings, 60% of respondents had their remote workstations set up before COVID, while 61% of radiologists working in academics had their set up during the pandemic. 

Non-academic readers tend to take on more remote interpretations, with 32% of them reporting that 75% of their reads are done remotely; that is the case for just 18% of academic radiologists, according to the data. 

In terms of returning to work sites, 27% of academic radiologists noted that they are expected to now return to on-site shifts, while just 8% of non-academic providers reported on-site requests. Of those in academics, 65% do intend to continue reading remotely, but that figure still falls short of the 82% in non-academic settings that have plans to remain remote. 

While there are both benefits and drawbacks to remote work, the imbalance between academic and non-academic radiologists working in remote settings observed in this study could have ramifications for the future workforce, authors of the JACR paper suggested. 

“Since academic departments are more likely to have radiologists return to on-site work, the degree of remote reading could become a factor that recently-trained radiologists consider when deciding between pursuing an academic versus a private practice career,” corresponding author Easton Neitzel, MS, with the Department of Radiology and Department of Student Affairs at the University of Arizona College of Medicine in Phoenix, and colleagues noted. “According to a recent nationwide poll, millennials are more likely than any other generation to desire a remote work option, with 84% rating remote work as important.” 

Remote reading is likely here to stay, the survey data suggest, with 84% of those who had read remotely before indicating that remote shifts will likely be a permanent staple in their department post-COVID, at least in some capacity. This was the case in both academic and non-academic settings and is something that organizations will need to consider in the future as they recruit new talent, the authors noted. 

To read more, go to Health Imaging.

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