Are you worried that legislators and policymakers are too busy to hear about problems facing radiology practices? Don't get worried, get involved, said Rep. Michael Burgess (R-TX), an ob/gyn physician serving in Congress, at this week's Radiology Business Management Association (RBMA) Fall Educational Conference.
Burgess was scheduled to speak on how the repeal of the sustainable growth rate (SGR) formula -- a goal he worked for during his entire career in Congress -- came about politically. However, as important as that topic was to him, there was something even more pressing that he wanted to discuss with RBMA members.
"I had a nice speech written, but I'm not going to read it to you," he announced at the start of his presentation.
Creating a mandate
Instead, Burgess drew the attention of RBMA members to how, in repealing the SGR, Congress also created a mandate to drive the adoption of clinical decision-support software. It also required the U.S. Centers for Medicare and Medicaid Services (CMS) to consult with radiologists and radiology groups on the development of the approved appropriate use criteria that would form the backbone for clinical decision support.
"There needs to be someone in the room who understands what it is that you do and why it is important to the patient," said Burgess, who is also chairman and founder of the Congressional Health Care Caucus. "And it is not just about preserving the past. If [the future] is going to be disruptive innovation and we are going to have the Amazon drone method of delivery for radiology, whatever that may be, you need to make sure that you are involved and that you are in the equation."
Burgess and the Lone Star Leadership Political Action Committee have launched a resource called the Stat Initiative for physicians and other healthcare providers who wish to get involved in public service. Burgess can't help members of another party running against a member of his own party; however, he said he is very open to talking to anyone in healthcare, regardless of political affiliation, about his own experience in politics if it would encourage more people with healthcare expertise to seek public office.
"We need to make sure people who represent your interests and your patients' interests are, in fact, included [in policy decisions], because if we don't show up, guess what happens: There are plenty of people who do show up, and they may not have your best interests or your patients' best interests at heart," he said. "That is how you get some of the things where you are just scratching your head and asking, 'How in the world did anybody ever think that was a good idea, and it is never going to work.' "
According to Burgess, one of the issues to become involved with right now is the 21st Century Cures Act. In addition to increasing funding for high-risk, high-reward research through the U.S. National Institutes of Health, the act repeals the multiple procedure payment reduction (MPPR) on the professional component of imaging and encourages interoperability in electronic health records.
The House of Representatives has passed the bill, but it still has to get through the Senate, Burgess noted. It could face an uphill battle there because it increases spending in the short term, even though it may ultimately reduce healthcare spending through the development of better treatments for expensive diseases.
"One of my frustrations is that in Congress, we live under the tyranny of the Congressional Budget Office," Burgess said.
The nonpartisan CBO is prohibited from assessing the cost of a bill any further out than 10 years, and it cannot use the type of risk-versus-reward budget analysis any business would use when strategically planning investments.
"We are never allowed to look further than 10 years out and understand what we may get back in savings," he said. "If the cost curve is dramatically bent down for Alzheimer's, congestive heart disease, or recalcitrant cancer, then the whole budget equation become a different thing, and that ultimately would be a good thing."
Burgess was unsuccessful in adding language to the Cures bill that would allow the CBO to factor in long-term savings from a policy change. However, he plans to reintroduce that idea in Congress, and he noted that such a proposed law would be very relevant for radiology.
"You are a big, slow target because you cost a lot, but imaging exams change people's lives for the better," he said. "In my grandfather's time, if you had to diagnose a placenta previa, it was a double setup in an operating room and it was a pretty dreadful thing for everyone involved. Now you do a sonogram."
The RBMA Fall Educational Conference took place September 27-29 in Austin, TX. The next RBMA national conference is the annual Radiology Summit, which in 2016 will be held April 24-27 at the Broadmoor in Colorado Springs, CO. Registration details will be announced on RBMA's website.
