News | Business | July 11, 2017

Neiman Institute Releases Updated Radiologist Patient-Facing Dataset

Data allows radiologists to determine if they are considered patient-facing, a key factor in MIPS reimbursement participation

Neiman Institute Releases Updated Radiologist Patient-Facing Dataset

July 11, 2017 — The Harvey L. Neiman Health Policy Institute has updated the Radiologist Patient-Facing Dataset (RPFD) with 2015 Centers for Medicare and Medicaid Services (CMS) data. This free resource allows radiologists to determine if they would be designated as patient-facing by CMS. This designation affects Merit-Based Incentive System (MIPS) participation. The tool also allows practices to look up all the radiologists in their practice to determine if they are likely to be exempt under the MIPS group reporting option.

Radiologists can use this updated dataset to look up their name and other radiologists in their practice to see if they would be designated as a patient-facing physician. Because CMS is using 2017 data for this determination, having the most recent CMS data available in the RPFD will allow radiologists to prepare if they are close to the patient facing threshold,” 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.”

RFPD was produced using the publicly available Physician and Other Supplier Public Use File which contains 100 percent of all Medicare FFS (fee-for-service) 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 combine 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.

“It is imperative that radiologists begin taking action now to be well positioned for success under the new program. The updated Radiologist Patient Facing Dataset (RPFD) is a great start for clinicians to determine what their patient facing physician designation will be in 2019.”

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