RBMA Hot Topic: ICD-10 Implementation Perception

RBMA’s Hot Topic Question of the week relates to the impending implementation of ICD-10. For the last year the date of implementation has continued to be pushed back, leaving providers unsure when it will really go into effect.  Most providers seem to be pleased by it’s delay because it means they don’t have to learn the new coding system, but it is only a matter of time before we all will need to adapt to the ICD-10 protocols.


The RBMA took to the forums to find out for real how health care professionals in radiology feel about ICD-10 and how it will affect their practice.  The survey is still running, but the largely negative response is overwhelming.  Participants were asked, “How do you think ICD-10 will affect your practice? Check all that apply.”  Options included:


  •  Decrease in coder productivity
  • No change in coder productivity
  • Increase in coder productivity
  • Decrease in coding denials
  • No change in coding denials
  • Increase in coding Denials
  • Delay in reimbursement
  • Decrease in reimbursement
  • No change in reimbursement
  • Increase in reimbursement

Participate in the survey > Click Here

Currently, the most popular responses reflect the belief that implementation will bring decreased coder productivity, increased coding denials, delayed reimbursement and decreased reimbursement overall.

So, what’s with the all this ICD-10 hating? First of all, there are SO many changes with the new codes. (Review them all here: ICD-10 Education) It is intimidating, especially for those who are already not experts with ICD-9 coding.  Many practices and organizations have kept their revenue cycle management in-house for so long, in an effort to cut costs and keep control, but that trend will come to an end. 

In theory, ICD-10 should help physicians improve their reimbursements and cut down denials, however that is only if the codes are used appropriately. Heed the warning signs and start preparing now, because ready or not… ICD-10 is coming.

Building Better Marketing Programs: RBMA Wrap-Up

The RBMA Building Better Marketing Conference in Long Beach, California went off without a hitch earlier this week, bringing together the best radiology professionals from all across the world.  On Sunday evening, the attendees mingled in the lobby of the Renaissance Long Beach hotel meeting new friends and reminiscing with the old. With the sound of an acoustic guitar in the background and the sea breeze filtering through the open doors, everyone knew we had arrived in Cali baby.

Monday morning is hard for everyone, but Terri Langhans opening presentation got everyone’s gears going for the week.  She asked us, “How do you stand out in an industry where everyone looks alike?” By comparing the radiology industry to the airline industry she led us to see the opportunities available to make ourselves stand out.  Think about the differences in flying Southwest versus Delta, even just the comedic way Southwest delivers their safety information. “You don’t have to be a comedian, you just have to have a personality,” Langhans quoted. Her message was to make sure we do small things with character, because the more similar you are, the more your differences matter.


In radiology, each touch point your patients have with your center matters.  A touch point is any point of contact, for instance; phone trees, parking, welcomers, front desk employees, techs, radiologists, schedulers, even your billing department. Langhans’ message essentially, is that your touch points should be talking points, or components that set you apart from the competition and contribute to a strong culture for your organization.

(Check out photos from the event on the RBMA Facebook Page here: https://www.facebook.com/RBMAConnect)

The schedule over the next two days was packed full of sessions covering content including:

-       Writing creative marketing/web content

-       Social media for radiology providers

-       Stark Law and Sunshine Act

-       Advancements in breast imaging

-       Search engine optimization

-       Selecting and utilizing a CRM

-       Rebranding techniques

-       Using referral metrics to drive business

-       Finding an “Open Table” model for radiology scheduling

-       Interventional radiology practice development

-       Imaging market changes and opportunities

-       Content marketing strategies

-       Customer service and efficiency

-       Campaign creation versus ads

-       Benchmarking for marketing and sales

-       Quality initiatives for independent hospital-based physicians

-       Advice for IDTFs competing with hospital systems


In addition to those very focused sessions, conference attendees gathered together for roundtables discussing marketing efforts they have used that were effective and the industry issues that have been keeping them up at night.  Tuesday morning was also kicked off by a 5 Minute Forecast from a panel of RBMA experts. All of whom were geniuses; well spoken and wonderful. (Cough, cough… this is shameless brag, as I was one of them.)  After the forecasts, which predicted increases in patient-consumerism, market transparency and the increased weight of strong industry relationships, the floor was opened up to the attendees and they were given the chance to ask any marketing questions they had up their sleeves. The session, entitled “Stump The Marketers,” was my favorite part of the entire conference because it enabled us to engage in candid conversation about the real issues we all face on a daily basis.   Topics covered included:

-       ICD-10 and the effect on marketing representatives: It was determined that the coding changes will give marketers a chance to stand out as early adopters and even give training opportunities to their referring offices.

-       Direct targeting and re-targeting campaigns for patients: Some wondered if this form of internet marketing could be considered invasive, but we decided that if the patient is already interested in you, they will perceive you in that way.

-       Utilizing technology for patient communication: We decided that nothing can be replaced by one-on-one communication and people do not want to be made more convenient. If a patient ops in for email or text reminders or event updates, that is another opportunity.

-       Spending money on traditional marketing and advertising like the phonebook: These historically expensive methods have no way of being measured as far as ROI goes, so most marketing pros have started to turn towards internet marketing instead.

Anyone that was a part of the conference will say that they learned a lot and will remember fondly how great the smartphone application was (especially with the neck-in-neck race between Erik W. and Brenda B. for top users), the great bartenders at "Sip", the great elevator struggle of 2014, the California-themed Quest Awards and how wonderful the RBMA faculty was for organizing such a spectacular event.

Overall the conference was a huge success. The RBMA team certainly knows what they are doing and each year the content and sessions get better and better. We are already looking forward to next year’s event, it is going to be in Nawlins’ after all!  Until next year everyone, can’t wait to see what all we will accomplish in 2014.

Marketing Quality Care to Patients

In light of a recent trip to Ft. Lauderdale for the RBMA’s Building Better Radiology Marketing Programs event, we have been thinking a lot about the best ways to market to patients.  In the healthcare industry, consumerism is on the rise, but coming up with creative and innovative ways to market your product is much harder with intangibles like care.  Of course positioning a shiny new toy or new techie product is going to be easier to sell since your can turn even an unwilling buyer into a customer in a 30 second commercial, however with the right campaign for care, you can gain adopters for a lifetime.

 healthcare marketing resized 600

The challenges that healthcare marketing professionals face are difficult, but easily combated if approached appropriately. Healthcare tends to make patients think negatively, as considering health services and procedures forces them to ponder flaws, pain, life and death. All of which are simply emotions that are not evoked when someone is trying to decide between the red iPhone case and the blue iPhone case. 

The ticket is balancing the emotional with the rational and adding a twist of creativity that engages the patient and makes them remember you.  Think about State Farm for instance. They are selling insurance. Nothing brings about negative thoughts more than losing everything when you have an accident, but their marketing campaigns have a special recipe for entertaining you while still having confidence in their services.


Both videos are selling the same product but by playing on two very different facets of human emotion, they both succeed and are memorable. This balance is just as easily attainable in the healthcare field.  The key is to think like a patient. This might seem like a simple solution, but by considering the care process your practice can easily determine strengths and examine what truly matters to patients. Ask the questions the patients are asking of your own practice.

-       Do they take my insurance?

-       How much is this going to cost me out-of-pocket?

-       Is this really the best price?

-       Are they going to take care of me and answer my questions?

-       What if something goes wrong?

-       Is this going to be scary or hurt?

-       Is their technology up to date?

-       Am I getting the care I deserve?

The healthcare industry is not what it used to be thanks to the Internet and patients are turning towards self-education and empowerment. It is important to assure their concerns, provide resources to them and treat them like the power-holders that they are.  Making sure that your patients are taking advantage of educational materials while knowing about price shopping and quality measurement tools is an intangible value-added service.  Make sure that your patients are comparing apples to apples and are aware of price transparency and they will feel assured that you want the best for them. After all, the goal of healthcare marketing is to put their minds at ease by combating fears with comfort and quality.

CMS to Cancel Group Practice Provision of MPPR-PC

The following announcement was released from the RBMA today regarding the CMS announcement regarding MPPR and further reimbursement reductions on services rendered by the same physician or group practice. The ACR and RBMA worked fervently, opposing this new policy, due to the impact these further cuts would place on American radiology professionals.

RBMA reimbursement

The Centers for Medicare & Medicaid Services (CMS) announced Friday that due to “operational limitations”, CMS’ contractors will not apply the Multiple Procedure Payment Reduction (MPPR) of 25 percent to the professional component (MPPR-PC) of subsequent CT, MRI, or ultrasound services to group practices in 2012.  The 25 percent reduction, effective January 1, 2012, remains in effect for subsequent CT, MRI, and ultrasound services when furnished to the same patient, by the same physician, during the same session on the same day.  The expansion of the MPPR-PC to group practices was opposed vigorously by the American College of Radiology (ACR).  RBMA also opposed the policy and supported the ACR’s efforts in recent meetings with CMS.

In last month’s final rule for the 2012 Medicare physicians’ fee schedule, CMS announced its plans to expand its Multiple Procedure Payment Reduction (MPPR) policy to the professional component (PC) of CT, MRI, and ultrasound services when furnished to the same patient, by the same physician or group practice (emphasis added), in the same session on the same day.  The procedure with the highest PC and technical component (TC) payments would be paid in full, but the PC payment of the subsequent procedure will be reduced by 25 percent.

CMS’ proposed rule for the 2012 Medicare physicians’ fee schedule included a 50 percent MPPR-PC but failed to mention it applying to physicians within the same practice. 

By publishing the group practice provision only in the final rule, ACR argued that the agency violated public rulemaking and that the group practice provision was counter to current subspecialty radiology patient care.  Bob Still, RBMA’s President-Elect, added that the provision would be difficult to implement for contractors and practices alike.

After this announcement on Friday, CMS released the following statement:

“The Medicare Physician Fee Schedule claims for services rendered on or before December 31, 2011, are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.  The Administration is disappointed that Congress has failed to pass a solution to eliminate the sustainable growth rate (SGR) formula-driven cuts, and has put payments for health care for Medicare beneficiaries at risk.  We continue to urge Congress to take action to ensure these cuts do not take effect.”

SGR Bill Passed House of Representatives Now On to Senate

Well we have dodged the first bullet, but there is still a whole war to be won concerning H.R. 3630, known as theMiddle Class Tax relief and Job Creation Act that was passed on December 13th by the U.S. House of Representatives.  The Act prevents a further 27% cut to Medicare physician reimbursement and provides physicians with a 1% increase in Medicare payments for 2012 and 2013. So far, there have been no additional medical imaging cuts, so kiss your babies but keep your fingers crossed folks, because we still have to make it through to the Senate.

There is still the concern that this act does not contain information from the Diagnostic Imaging Services Access Protection Act (H.R. 3269), which protects against the implementation of a 25% payment reduction on professional fees for multiple MRI, CT and ultrasound procedures.  Fortunately, there are 127 supporters of H.R. 3269 in the House of Representatives and the ACR has announced that they will continue on their plight to add the language from H.R. 3269 as the SGR legislation heads to the Senate.

This SGR adjustment means good things but since it still does not address the proposed rule from CMS that would severely cut the Medicare reimbursement rate for radiologists who interpret multiple images, we have to hope that pressure from all concerned, including the ACR, pushes the Bill through. Although this is certainly a step in the right direction, this could just be a “quick fix” and the proposed cuts to radiologists would be the 8th cut in the past six years to Medicare funding for Diagnostic Imaging.  The seven cuts that have occurred over these past six years have totaled more than $5 Billion and with imaging growth at less than 2% annually, additional cuts would end up limiting American’s access to quality diagnostic imaging due to the facilities that would suffer and end up closing their doors if the cuts went through. Republican representative James Renacci did introduce a legislation that would allow for a six-month grace period for new diagnostic imaging centers, so that those certain suppliers of Medicare imaging services could bypass the MIPPA accreditation requirement to receive reimbursements during that period of time.  The grace period begins when a new physician or facility submits images to the accreditation process and ends either with the approval or denial of their request, or after 6 months have commenced.  The center will be able to receive reimbursements during this time, however if they are unable to get accredited by the end of the period, any reimbursements they received would need to be paid back.

It can be assumed that due to the Senate’s Democratic leadership, they will attempt to create their own version of the legislation that will include a one to two year “doc fix,” which equates to questionable Senate action timing.  TheRBMA estimates that a package will be put together by the end of the week and voting will take place Monday or Tuesday, dependent upon the ability to create a package that gains some Republican Senate support.  This brings a whole new meaning to the term, a house divided sports fans, and we could end up waiting on a decision until well into 2012.