January 19, 2017 — A new free resource allows radiologists to determine whether they would have been designated as patient-facing by the Centers for Medicare and Medicaid Services (CMS) from 2012 through 2014. Developed by the Harvey L. Neiman Health Policy Institute, the Radiologist Patient Facing Dataset (RPFD) allows users to look up all the radiologists in their practice to determine if they are likely to be exempt under the Merit-Based Incentive System (MIPS) group reporting option.
“Radiologists can use this dataset to look up their names and other radiologists in their practice to see if they would have be designated as a patient-facing physician, their total CMS fee-for-service (FFS) procedures, total CMS patient facing procedures, and percent of procedures classified as patient facing for each year between 2012 through 2014,” said Danny R. Hughes, Ph.D., Neiman Institute senior director for health policy research and senior research fellow. “Using this and other Neiman Institute online data tools, radiologists can prepare and succeed in CMS’ evolving payment models.”
RPFD was produced using the publicly available Physician and Other Supplier Public Use File which contains 100 percent of all Medicare FFS performed and aggregated by Current Procedural Terminology (CPT) code and individual physician. RPFD contains each physician reported as a Diagnostic Radiologist, Interventional Radiologist or Nuclear Medicine specialty in the Physician and Other Supplier data, sorted alphabetically by last name.
As part of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, CMS established a new Quality Payment Program (QPP) designed to tie physician payments to quality and value. Under QPP, physicians not participating in advanced alternative payment models (APMs) are eligible for MIPS, which combines traditional FFS base payments with payment adjustments based upon physician performance across four categories: Quality, Advancing Care Information (ACI), Improvement Activities and Resource Use.
“The effect of the non-patient facing determination has particular impact on the ACI category, as these measures are difficult for radiologists to meet,” said Gregory Nicola, M.D., chair of ACR’s MACRA Committee. “As a result, it is important to understand under what conditions a radiologist would be defined as non-patient facing and thus automatic reweighting of the ACI category so that it would not factor into their MIPS total score. Additionally, radiologists should understand that they may also have the ACI category reweighted to zero automatically based on status as a hospital-based clinician. Thirdly, radiologists may meet other criteria, for which manual application is needed, to have the ACI category reweighted to zero.”
For more information: www.neimanhpi.org