ACR solicits comments to bolster Medicare pay-for-performance program

September 10, 2007

The American College of Radiology has asked members for feedback on a draft of clinical performance measures involving several radiology subspecialty areas. The measures, designed to improve the quality of medical services, may be used to support pay-for-performance plans sponsored by the Centers for Medicare and Medicaid Services.

The American College of Radiology has asked members for feedback on a draft of clinical performance measures involving several radiology subspecialty areas. The measures, designed to improve the quality of medical services, may be used to support pay-for-performance plans sponsored by the Centers for Medicare and Medicaid Services.These clinical performance measures could potentially affect how radiologists provide care to patients and boost the prospects for getting a bonus payment for exceptional work. However, the bonus part of the program is not guaranteed to continue beyond 2007, said Mark Gorden, senior director for the ACR's Pay for Performance Initiatives program."The more member comments, the better as far as getting the measures right, accurate, responsive to what our membership areas of specialty are, and in a way that is easily reportable. Getting radiologists' comments will affect what happens to them next year if they decide to report under this program," Gorden said.

CMS's Physician Quality Reporting Initiative offers physicians who report to the program up to a 1.5% bonus over their Physician Fee Schedule billings for submitting quality data on the Medicare claim forms. The PQRI for 2007 includes eight measures related to diagnostic and interventional radiology as well as radiation oncology:

  • stenosis measurement in carotid imaging reports
  • BI-RADS data collection
  • inappropriate use of BI-RADS category 3 in mammography screening
  • communication of suspicious findings from the diagnostic mammogram to the practice managing ongoing care
  • communication of suspicious findings from the diagnostic mammogram to the patient
  • reminder system for screening mammograms
  • CT radiation dose reduction
  • exposure time reported for procedures which use fluoroscopy

The Radiology Workgroup of the American Medical Association's Consortium for Performance Improvement developed these performance measures. The measures will not establish clinical guidelines or medical care standards, and they are not meant to evaluate a physician's performance at this stage. They are aimed only at gathering information on quality care, Gorden said.

The program started last July and runs through the end of December 2007. Participation is voluntary. The 41-page draft with the proposed measures have been posted for public comment on the

National Committee for Quality Assurance

web site. The deadline for comments is Sept. 25.

"The comments gathered during this period will definitely be reviewed and considered before the measures are finalized. It's important to get that input," said Judy McKenzie, ACR director of metrics.For more information from the Diagnostic Imaging archives:

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