Radiology Digest – November 8, 2022

November 3, 2022

Radiology Digest: News from the week of November 8, 2022.

Final 2023 Physician Fee Schedule Out from CMS; Early Reactions Register Exasperation, Resolve
By Dave Pearson | November 3, 2022 | Included in Radiology Digest – November 8, 2022

CMS has finalized the Medicare Physician Fee Schedule (MPFS) for 2023, and its reimbursement reductions for radiology are less harsh than those proposed preliminarily in July.

The 2023 conversion factor will fall from $34.6062 in 2022 to $33.0067 in 2023. This will trigger an overall pay decrease of around 2% across radiology, according to an initial analysis by the American College of Radiology, which had summer’s proposed rule slashing the specialty’s pay by a full percentage point more.  

Rates for related specialties and subspecialties are to be similarly less hard-hit than expected, with interventional radiology taking a 3% plunge (vs. 4% projected), nuclear medicine 2% (vs. 3%) and radiation oncology and radiation therapy 1% (same as projected).

Still, the final rule document, issued Nov. 1, is a bitter enough pill to swallow that pointed words of weary protest immediately arose from some major groups representing physicians and practices.

“As expected, CMS finalized a substantial reduction to the conversion factor—negatively impacting physician reimbursement across the board,” Anders Gilberg, senior VP of government affairs with the Medical Group Management Association (MGMA) said in written remarks Nov. 2. “It is more critical than ever that Congress act to avert these cuts, as well as the 4% PAYGO sequestration, before the end of the year. … MGMA looks forward to working with both Congress and the Administration to mitigate these cuts and develop sustainable payment policies to allow physician practices to focus on treating patients instead of scrambling to keep their doors open.”

To read more, go to Radiology Business.


Another Isotope Shortage Looms as Mechanical Failure Delays Production
By Hannah Murphy | November 1, 2022 | Included in Radiology Digest – November 8, 2022

The nuclear medicine community should be advised that there is an impending shortage of molybdenum-99 (Mo-99)/technetium-99m (Tc-99m), according to a communication shared by Nuclear Medicine Europe (NMEU). 

In a meeting held on Oct. 28, the NMEU Emergency Response Team (ERT) was informed that a mechanical failure was discovered at the BR2 reactor, located in Belgium, during inspections. For this reason, the investigations must continue, and the reactor’s restart date is being delayed. It will not resume operations until Nov. 18 at the earliest.  

Inevitably, this will result in disruptions in the supply of Mo-99 and Tc-99m—medical radioisotopes that are crucial to the field of nuclear medicine—until at least the end of November. According to an estimate by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), Tc-99m is utilized in approximately 50,000 medical procedures per day in the United States alone. 

Compounding the consequences of the mechanical failure, in August, NMEU announced a planned outage at one of the reactors that produces I-131. Stakeholders were informed that this outage could periodically disrupt the supply of the isotope from September 2022 through February 2023. This latest discovery at the BR2 reactor could exacerbate the isotope shortage further, the NMEU statement indicates. 

As a mitigation tactic, NTP Radioisotopes—a subsidiary of the South African Nuclear Energy Corporation—will extend the cycle of its SAFARI reactor by one week. According to NTP, the SAFARI reactor supplies up to one-third of the global supply of Mo-99. 

The NMEU communication suggests that other mitigation measures are also being considered due to the unplanned delay at the BR2 reactor. The next update on the situation will be shared during the Emergency Response Team meeting being held on Nov. 4.  

To read the statement from NMEU, click here
For information on the planned outage said to potentially impact Mo-99 supply through February 2023,click here

To read more, go to Health Imaging.


AI Literacy Program Earns Stamp of Approval from Radiology Residents
By Hannah Murphy | October 31, 2022 | Included in Radiology Digest – November 8, 2022

With the use of artificial intelligence in radiology gaining momentum daily, experts are suggesting implementing an AI literacy course to increase understanding of the technology and its numerous applications. 

Such a course was recently incorporated into clinical curriculum at nine radiology residency programs in the Southeast and Mid-Atlantic United States with great success, according to a new paper published in Academic Radiology. In the paper, experts reported that nearly 80% of program’s participants expressed interest in continuing their knowledge of AI in radiology

“Just as prior inventions such as computed tomography and magnetic resonance imaging have revolutionized medicine, and digital advancements in the electronic medical records, picture archiving and communication system, and the radiology information system have substantially improved efficiency and the quality of care, AI will likely be the field’s next generation defining breakthrough,” corresponding author J.D. Perchik, MD, of the University of Alabama at Birmingham and co-authors wrote.

While the integration of AI on some level into routine medical imaging practice has already occurred at numerous institutions, many radiology residents have reported feeling inadequately informed of its applications. For example, 96.7% of residents from the nine programs included in this latest research reported a lack of sufficient exposure to AI during their training. 

To overcome this limitation, experts developed a week-long AI in radiology course to introduce residents to a multitude of basic AI concepts and applications, including subject matter pertaining to subspecialty uses, economics, ethics, algorithm bias and medicolegal implications of AI. The course included ten 30-minute remote lectures and an in-person hands-on session that allowed participants to work directly with an FDA cleared AI device. 

To read more, go to Health Imaging.


Employers are Optimistic About the Future of Telemedicine: 5 Numbers to Know
By Rylee Wilson | October 31, 2022 | Included in Radiology Digest – November 8, 2022

Employers remain optimistic about the future role of telemedicine, even as pandemic restrictions ease, according to Kaiser Family Foundation’s annual Employer Health Benefit survey. 

The survey, published Oct. 27, includes 2,188 non-federal public and private firms with three or more employees. 
Here are five findings from the survey on the role of telemedicine in employer benefits: 
 Among small firms with 50 to 199 employees, 87 percent cover at least some health services through telemedicine. Among large firms, this number is 96 percent. These percentages are much higher than they were three years ago. In 2019, 65 percent of small firms had telemedicine benefits and 82 percent of large firms did. Among companies with more than 50 employees, 34 percent expect the use of telemedicine to increase in 2022 compared to last year, 14 percent expect it to decrease and 42 percent expect it to stay about the same.Employers surveyed think telemedicine will be important for several kinds of care. Among companies with more than 50 employees, 36 percent said that telemedicine will be very important in providing access to behavioral health services in the future, and another 31 percent said it will be important. Employers think telemedicine is important for employees in remote or rural areas. Of the employers surveyed, 40 percent said that telemedicine will be very important in providing future access to care for enrollees in remote areas, and another 27 percent said it will be important for providing care.To read more, go to Becker’s Payer Issues.


14 House Members—7 Democrat, 7 Republican—Press CMS to Step Up Its Game on CCTA
By Dave Pearson | October 30, 2022 | Included in Radiology Digest – November 8, 2022

A bipartisan group in the U.S. House of Representatives is asking the Centers for Medicare and Medicaid Services to acknowledge the cost-effectiveness of coronary CT angiography (CCTA) by comprehensively covering the exam for patients who present with acute but stable chest pain or other early signs of arterial plaque buildup.

In a letter sent Oct. 25 to CMS head Chiquita Brooks-LaSure, an even split of Republicans and Democrats, 14 in number, amplify new guidelines from the American College of Cardiology (ACC), American Heart Association (AHA), Society of Cardiovascular Computed Tomography (SCCT) and other groups.

Those guidelines, published a year ago in the Journal of the American College of Cardiologydistinguished CCTA with a Class 1 recommendation and an evidence level of “A” for patients with stable and acute chest pain.

Since then, demand has been growing for CCTA—which yields 3D visualization of blood flowing through arteries to the heart—as a frontline noninvasive test for patients with suspected coronary artery disease.

Moreover, the signatories of the letter to CMS point out, the new guidelines were published “in response to overwhelming clinical evidence demonstrating that use of CCTA leads to a 41% lower rate of death and heart attack compared to stress testing, allows clinicians to cancel greater than 75% of planned invasive procedures and saves the Medicare program more than $3,100 per patient.”

To read more, go to Radiology Business.
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