Association to Develop Proposal for Radiology-Specific Alternative Payment Model

April 24, 2023
Objective of the model would be to drive value in radiology and generate taxpayer savings by reducing unnecessary utilization of Medicare radiology services

The Radiology Business Management Association (RBMA) board of directors recently approved a proposal to develop a new radiology alternative payment model.

The objective of the newly developed model would be to drive value in radiology and generate taxpayer savings by reducing unnecessary utilization of Medicare radiology services while preserving and enhancing the quality of care.

RBMA is comprised of nearly 2,000 professionals who focus on the business of radiology. RBMA members support diagnostic imaging, interventional radiology and radiation oncology providers in the full spectrum of practice settings.

For the past 15 years, RBMA claims, radiology has experienced a devastating decline in reimbursements under the Medicare Physician Fee Schedule. RBMA’s board said now is the time to begin discussions with Congress and the Centers for Medicare and Medicaid Services (CMS) regarding a new model for physician payments.

“The time has come to advance a proposal to both Congress and CMS regulators that will ensure high-quality imaging and patient access,” said Bob Still, RBMA executive director, in a statement.

Participation in the newly developed model would be voluntary, RBMA stressed. It would be based on benchmarks to establish both risks and rewards that could generate shared savings for radiology, with quality metrics to ensure certain quality requirements are met, including utilization of appropriate use criteria.

“A radiology-specific APM is an important step in ensuring that high-performing practices receive reimbursement reflective of the value they provide Medicare beneficiaries,” said RBMA President Kit Crancer, in a statement. “I’m looking forward to working with organizations across the country to develop and offer new, innovative approaches to improving patient outcomes.”

RBMA’s leadership and its grassroots advocacy network, RPAN (Radiology Patient Action Network), will work to build further details regarding the advanced alternative payment model with the goal of beginning discussions with key Congressional leaders this year.

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