Radiology Digest – May 6, 2022

May 9, 2022

Radiology Digest: News from the week of May 6, 2022.

Most States’ Breast Cancer Screening Plans Do Not Comply with USPSTF Guidelines
By Hannah Murphy | May 3, 2022 | Included in Radiology Digest – May 6, 2022

Many comprehensive cancer control (CCC) state plans do not align with that of the U.S. Preventive Services Task Force (USPSTF) when it comes to breast cancer screening guidelines.

The discrepancies are based on when exactly women should begin and end breast cancer screening when they are at average risk.

“All of the organizations with recommendations agree on the benefits of breast cancer screening for women at average risk,” corresponding author Norma F. Kanarek, PhD, MPH, of the Department of Environmental Health and Engineering at Johns Hopkins University Bloomberg School of Public Health in Baltimore, and co-authors write. “However, the ages at which women should start and end mammography examinations and the frequency of mammography examinations have been a matter of political, emotional, and scientific debate for 3 decades.”

These particular guidelines have undergone multiple changes over the years, and depending on the organization, the recommendations do vary. Further complicating the matter is insurance and government coverage mandates that require insurers to pay for breast cancer screenings based on risk and age. Additionally, the Centers for Disease Control and Prevention requires compliance from states in order to receive funding for comprehensive cancer control planning.

Experts recently compared these state CCC plan objectives to that of the USPSTF to evaluate for consistency and found that most states’ plans do not align with the most recent (2016) guidelines for screening. Of the 51 plans, just 31% were consistent with the USPSTF recommendations pertaining to the age and frequency of screening women at average risk. Almost half of states were at least partially consistent, and 9 plans did not comply with any of the recommended guidelines.

The full study can be viewed at JAMA Network.

To read more, go to Healthcare Imaging.

Video: Preparing for Radiology Appropriate Use Criteria Clinical Decision Support Reporting Requirements
By Dave Fornell | May 3, 2022 | Included in Radiology Digest – May 6, 2022

Lisa Mead, PSO executive director, Strategic Radiology, spoke at the Radiology Business Management Association (RBMA) 2022 meeting on radiology practices being prepared for the January 2023 deadline to have appropriate use criteria clinical decision support (AUC/CDS) software operational.

However, this mandate has been pushed back annually since 2016 when it was first supposed to go into effect, and there are questions if it will be delayed yet again. Several medical imaging societies are calling on Congress to repeal the AUC/CDS mandate because they believe it will cause delays in care, involve more administrative staff time, add costs to healthcare and delay new guidelines and recommendations from being quickly added into CDS systems.

The Centers for Medicare and Medicaid Service (CMS) said beginning Jan. 1, 2023, claims submitted without compliance certificates from CDS will be rejected. Mead’s RBMA session provided a refresher on the AUC/CDS requirements and discussed methods that are working or not in getting prepared. She also reviewed the components of the AUC/CDS program to communicate the AUC/CDS program mandated by PAMA, and the methods that can be utilized by practices to successfully coordinate hospitals and referring providers in program implementation.

To read more, go to Radiology Business.

Prior Authorization ‘Gold Card’ Bills Spark Conversations in States
By Maya Goldman | May 3, 2022 | Included in Radiology Digest – May 6, 2022

Prior authorization has long caused professional strife for Dr. Zeke Silva, a San Antonio-based radiologist. But last year it became personal.

His wife had breast cancer, and her doctors wanted to schedule an MRI. Their insurer denied the request. She eventually got the procedure approved, but it was delayed.

Silva hopes to see these situations less now that Texas passed a statewide prior authorization “gold card” law. The measure requires insurers to exempt providers from pre-authorization for certain services if they achieve a 90% approval rate for the service over six months.

“I’m looking forward to a time where, because of that gold carding status and satisfying that 90% threshold, that I can look a patient in the eye and tell them confidently ‘This is what I’m recommending. … Oh, and by the way, you and I don’t have to go through a prior authorization process to make this happen,’ ” Silva said.

Nearly 90% of providers said prior authorization felt very burdensome, according to a 2021 Medical Group Management Association survey. And it’s not just a burden issue—24% of physicians surveyed by the American Medical Association last year said their patients often abandon care after facing pre-authorization.

To read more, go to Modern Healthcare.

Remote Shifts Boost Radiologist Well-being and Dilute Physician Burnout
By Hannah Murphy | May 2, 2022 | Included in Radiology Digest – May 6, 2022

Hybrid schedules that enable radiologists to work from home might be the solution to dampening physician burnout.

More than half of radiologists at Penn State Hershey Medical Center who participated in a flex schedule that enabled them to work from home part time reported that the schedule improved their clinical and academic productivity and positively influenced their impressions of their institution. Based on the burnout surveys staff completed both before and after the hybrid schedule implementation, those who participated in the change experienced better overall work/life balance as well. And the benefits of teleradiology don’t stop with employee well-being, they show up in turnaround times and clinical workflows too, the authors of a new study in Clinical Radiology report.

“Teleradiology, first practiced in the 1990s, can minimize workroom interruptions,” corresponding author Jonelle M. Petscavage-Thomas, MD, MPH, Professor of Radiology, Vice Chair of Clinical Affairs and Director of Medical Image Management at Penn State Hershey Medical Center, and co-authors explained. “Whereas prior to the pandemic, internal teleradiology was primarily used for on-call and weekend coverage this changed rapidly in March 2020 as many radiology practices moved to or increased their use of internal teleradiology to ensure a reserve of radiologists with lower exposure to COVID-19 who could sustain operations.”

As the world settles into the endemic stage of COVID, radiologists at Penn State Hershey Medical Center are continuing to work using a hybrid internal teleradiology model that was introduced during the early phase of the pandemic to mitigate spread of the virus. The schedule consists of procedural and educational attendings alternating working in the hospital or remotely to keep the worklist clean. Recently, the institution distributed faculty wellness/burnout surveys to measure the hybrid schedule’s success according to staff, in addition to comparing differences in report turnaround times (RTAT) recorded during remote shifts.

View the full survey results in Academic Radiology.

To read more, go to Health Imaging.

End of Relief Aid Pressures Safety-net Hospitals, Uninsured
By Marissa Plescia | May 2, 2022 | Included in Radiology Digest – May 6, 2022

The ending of federal program funds for COVID-19 relief is threatening uninsured patients who delayed care, as well as financially struggling safety-net hospitals that provide uncompensated care, The New York Times reported May 1.

Relief funds created something similar to a “universal coverage system within a system” that provided coverage to everyone with the virus, John Graves, health policy professor at Vanderbilt University School of Medicine, told the Times. The Provider Relief Fund gave hospitals tens of billions of direct funding, while the COVID-19 Uninsured Program gave more than $20 billion in reimbursements to about 50,000 hospitals, clinics and other providers.

Although COVID-19 hospitalizations are tapering off, safety-net hospitals are getting an influx of patients who delayed care for chronic conditions and other health problems that worsened over time and have become more complicated to treat.

The issue is especially challenging in Tennessee, which has one of the highest rates of hospital closures in the U.S. and has not expanded Medicaid, according to the Times. About 300,000 people are in the “coverage gap” and are ineligible for Medicaid or discounted health insurance but have little to no income.

To read more, go to Becker’s Hospital Review.

Abbreviated Breast MRI Deemed an Attractive Screening Option—Sometimes
By Dave Pearson | April 28, 2022 | Included in Radiology Digest – May 6, 2022

Abbreviated breast MRI is a cost-effective means of screening women with dense breast tissue for breast cancer—as long as the per-exam costs don’t top 82% of what would have been spent to perform full-protocol breast MRI.

Researchers in Germany made the finding after analyzing recently published data on abbreviated breast MRI (AB-MRI) alongside similar data on digital breast tomosynthesis and standard mammography, as well as full breast protocol MRI (FB-MRI).

The data originated in prospective, multicenter screening trials. To quantify the relative costs and benefits of the various modalities, the team modeled the economic effects of biennial screening based on quality-adjusted life years (QALYs) from the perspective of the U.S. healthcare system.

Corresponding author Clemens Kaiser, MD, of Heidelberg University in Germany and colleagues describe their work in a paper published open-access April 28 in European Radiology.

“At an assumed cost per examination of $263 for AB-MRI (84% of the cost of a FB-MRI examination), the discounted cumulative costs of both MR-based strategies accounted comparably,” Kaiser and co-authors report.

To read more, go to Radiology Business.

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