THE AMERICAN COLLEGE OF RADIOLOGY: PRIORITIES FOR 2017-2018

William T. Thorwarth Jr. MD, FACRCEO, American College of Radiology

Texas Radiological SocietyMarch 24, 2018

DISCLOSURESNo financial disclosures

butI must disclose being a 37 year member of the

ACR and am grateful for the value it has brought to every aspect of my professional career.

ACKNOWLEDGEMENTS James Brink MD, FACR – ACR Board Chair Geraldine McGinty, FACR – ACR Board vice-Chair

PRIORITIES Strategy Brand assessment and positioning Establish focus for ACR Foundation

Health Policy Research Planning for likely scenarios

Industry Consolidation, AI Advocacy / Economics

Prepare members for MACRA Strengthen tools for State Chapters

Support Committee on Chapters

PRIORITIES Education Annual meeting restructure: promote governance Radiology Leadership Institute

Quality and Safety Enhance robustness of AUC for CDS Enhance Peer-Learning opportunities

Diversity Increase awareness / make a difference

Strategic Planning Continuum Strategic Plan adopted 2014

3 to 5 year time frame Program Assessment launched 2015

Focusing resources Brand Assessment/Positioning 2016

For external stakeholders For house of radiology/medicine

Strategic Plan Performance Review 2017 Opportunity for mid course corrections

REASONS TO CHANGE A STRATEGIC PLAN

Shifts in internal and/or external conditions.

Sufficient progress has been made on goals and/or objectives.

Objectives need to be revised to make progress on the goal.

ACR STRATEGIC PLAN REFRESH FALL 2017

Reaffirmed Core Purpose:

To serve patients and society by empowering members to advance the practice, science, and

professions of radiological care.

Leadership Integrity Quality Innovation

ACR STRATEGIC PLAN REFRESH – FALL 2017

Environmental Assessment Trends in radiology and healthcare which may impact

ACR members Five broad themes

Demographics Economics Professional Structure Informatics Technology

ACR STRATEGIC PLAN REFRESH – FALL 2017

Some of the trends Identified Rise of consumerism Increased focus on outcomes measures/population

health Practice consolidation and service line reorganization Expansion of artificial intelligence applications and

opportunity for radiologists to define the ecosystem Rise of non-imaging diagnostics, especially in

genomics

ACR STRATEGIC PLAN REFRESH – FALL 2017

Board of Chancellors and Council Steering Committee used a two-step process Apply results of environmental assessment Review progress made on current Plan goals

Resulting in reaffirmation of 5 out of 6 goals… with a more expansive focus for the College

…and development of a new goal for Data Science

ACR STRATEGIC PLAN REFRESH FALL 2017

Data Science goal - Added To advance data science as core to clinically

relevant, safe, and effective radiologic care.

ACR STRATEGIC PLAN REFRESH – FALL 2017

Healthcare Payment Policies/Practice Models Emphasis on continuing ACR’s leadership role and

educating practice leaders and members-in-training

Membership and Member Engagement Focus on member experience

to maximize the effectiveness of the Council to enhance wellness among members to facilitate leadership development through chapters/Council

ACR STRATEGIC PLAN REFRESH – FALL 2017

Radiology and Patient Centered Care Focus on partnership with patients and families Inclusion of population health management

Innovation and Research Focus on patient outcomes and patient experience New objectives: To increase understanding of the impact of ACR

research

ACR STRATEGIC PLAN REFRESH – FALL 2017

External Relationships Focus on House of Medicine with

inclusion of medical specialties Add emphasis patient advocacy groups International radiology

organizations for strategic engagement and collaboration

ACR Strategic Plan Refresh – Fall 2017

Revised and updated Plan More expansive approach than 2014

Plan Population health, member

experience, diversity and inclusion, artificial intelligence

Emphasis on support for Council and state chapter leaders

A strong and clear guide for the ACR

What is ACR’s brand promise?- Is it persuasive, relevant and personally compelling?- Is it different among different stakeholder groups (e.g.,

members, prospective members, policy makers, public, external organizations and ACR staff)?

- How broadly and intimately do our stakeholders know ACR’s brand promise?

“BRAND” ASSESSMENT TASK FORCE

Task Force and Staff Actions Research completed Quantitative member and stakeholder survey

done in November, 2017 Full report with recommendations coming to

BOC

BRAND ASSESSMENT AND POSITIONING

CONFLICT OF INTEREST TASK FORCE Intended to address misperceptions that ACR

leadership has complex financial relationships that influence decision making

Task Force Launched May, 2016 Case Studies presented Jan., 2018 COI Policy Recommendations May, 2018

ACR FOUNDATION STRATEGIC PLAN

2016 retreat recommended and board approved revised focus on Health Policy Research

Includes Neiman Health Policy Institute Produces research directly influencing policy

Unique and distinct from other radiology funds and foundations (e.g. RSNA R&E, Roentgen Funds)

Neiman Health Policy Institute

Mission:Study the role and value of radiology and

radiologists in evolving health care delivery and payment systems

NEIMAN HEALTH POLICY INSTITUTE

Produces research directly influencing policy CMS MACRA Final Rule adopted our

recommendation of >100 patient facing encounters to be designated “patient facing” for MIPS participation

HPI ASSISTING MEMBERS

Numerous JACR articles on MACRA/MIPS Information for practices to cope with evolving

payment reform: Radiology Patient Facing Dataset:

(http://www.neimanhpi.org/patient-facing/) to help radiologists determine if they will receive special consideration under MIPS

LEADING THE WAY

Radiology Associates of North Texas Texas Radiology Associates

Triple impact due to matches by ARSF and ACR

AND INDIVIDUAL DONORSPaul Weatherall

Zeke SilvaJames Murphy

Steven HuangShah Baiju

Thank you all for your vision!

SCENARIO PLANNING Scenario planning exercises are intended to

anticipate possible futures and react to them prospectively

“In this business, by the time you realize you’re in trouble, it’s too late to save yourself. Unless you’re running scared all the time, you’re gone”

-- Bill Gates

SCENARIO PLANNING

• 2009: ACR, SCARD Scenario Planning• Neither anticipated potential impact of artificial

intelligence, machine learning• Many drivers will push our specialty in different

directions• MACRA, AI, Consolidated practice models

• 2016: Board exercise

STRATEGIC LEARNING INITIATIVE

Factors affecting healthcare are numerous and fast-moving

Need to recognize in real time changes in the environment, policy, and technology that affect radiology ACR Office of Strategic Planning and

Business Excellence (OSPBE)

Commission On Economics

Commission on Quality and Safety

Commission On Informatics

Commission on Patient and Family

Centered Care

Government Relations

Outstanding ACR Staff

Specialty Commissions

Neiman Health Policy Institute

ACR Members And Our Patients

ACR MACRA WORKGROUP

ANTHEM’S NEW ADVANCED IMAGING PRIOR

AUTHORIZATION POLICY

TIMELINE OF POLICY ROLL-OUTJuly 1, 2017:

IndianaKentuckyMissouri

Wisconsin

September 1, 2017:ColoradoGeorgiaNevada

New YorkOhio

December 1, 2017:California

March 1, 2018:Connecticut

MaineVirginia

ACR Position on Anthem’s Policy ACR opposes this aggressive economically-driven steerage

policy.

ACR would equally oppose a reverse steerage policy arbitrarily moving patients from the independent imaging center to the hospital setting.

Regardless of where radiologists practice, allowing this policy to stand will accelerate the commoditization of diagnostic imaging.

Anthem’s policy makes patients pawns in insurer-hospital negotiations, and inserts a wedge between patients and their physicians and radiologists.

ACR ANNUAL MEETING

After 3 years of an all-member, education-focused program, attendee feedback was clear Educational programming and Council sessions

competed at expense of key Council activities

Decision: ACR 2018 and beyond will be a Council-

focused meeting with limited additional programming

in support of chapter, RFS & YPS needs

RADIOLOGY LEADERSHIP INSTITUTE

RADIOLOGY LEADERSHIP INSTITUTE (RLI)

RLI awarded “Best Radiologist Training Program” by Aunt Minnie for 2014 and 2016

Summit at Babson College Sept. 7-9, 2018 RLI program modules completed to teach ABR

milestones to 19 enrolled residency programs

CLINICAL DECISION SUPPORT

24 years of continuous work Hundreds of clinical experts Multi-specialty based >6000 literature references AHRQ NGC approved Continuously updated Fully transparent Widely referenced

ACR Appropriateness Criteria At The Point Of Care

ACR SELECT USE WIDESPREAD

R-SCAN Participation: >100 practices with >3000 radiologists Radiologists and referrers get “high value

Improvement Activity under MIPS ABR and ABIM award MOC Part 4

Results, reduction in inappropriate imaging: 1 of 4 Support and Alignment Networks (SANs)

recognized at the CMS February Quality Conference for generating results showing reduced unnecessary testing

BUT RADIOLOGISTS NEED SUPPORT AS WELL

Need for standardized reporting Perception that radiologists commonly

recommend additional imaging Evidence based and consensus criteria on

appropriate recommendations exist but are complex and not consistently followed

40

REDUCING VARIABILITY

REDUCING VARIABILITY

“Agreement is lacking, both across institutions and within departments,

for the management of 6 commonly encountered incidental

findings on body CT.”

COMPUTER ASSISTED REPORTING

ACR ASSIST

September, 2012

2012 IOM REPORT: BEST CARE AT LOWER COST

“…eligible professionals will be able to meet the MIPS

quality reporting requirements by

participation in a QCDR.”

PATIENT-AND-FAMILY-CENTERED CARE TOOLKIT

A new, dynamic resource to help you improvepatient- and family-centered care in your practice.

STAFF WITH A HEART Hurricane relief fund grand total, including

excellent effort by all locations:

$26672

SUMMARY ACR with over 2000 volunteers and an

incredibly dedicated staff have been working on your behalf to fulfill our Core Purpose.

We represent radiologists in all practice environments/structures and are your career partner.

THANKS

wthorwarth@acr.org