Radiology Summit — Sessions
Monday, May 24, 2010
8:30 am – 8:45 am
President's Welcome
Cindy Pittmon, RCC, CHBME
RBMA President
8:45 am – 10:15 am
KEYNOTE LECTURE SERIES sponsored by 
Leading at the Speed of Trust
Stephen M.R. Covey
Click here to listen to a preview of Stephen M.R. Covey
The Speed of Trust challenges our age-old assumption that trust is merely a soft, social virtue and instead demonstrates that trust is a hard-edged, economic driver – a learnable and measureable skill that makes organizations more profitable, people more promotable, and relationships more energizing. This fast-paced and engaging presentation dramatically reveals TRUST as the hidden variable that will become your most leveraged tool, fueling your current strategic imperatives. We call it "Leading at the SPEED of TRUST."
At the end of this session, the learner should be able to:
- Make the business and economic case for trust.
- Show how the ability to generate trust is the critical leadership competency in this new global economy.
- Demonstrate how to master the skill of engendering trust – both personally and in your organization.
11:00 am – 12:30 pm
KEYNOTE LECTURE SERIES sponsored by
Leading at the Speed of Trust (continued)
Stephen M.R. Covey
Join Stephen M.R. Covey as he concludes his keynote session and further explains how you can establish, grow, extend and rebuild trust in both your personal and professional life.
1:30 pm – 2:30 pm
CONCURRENT SESSIONS
- At the Precipice: Are We Going to Fall?
Michael Bohl, RT, MHA, Christie James, MS and Robert T. Still, MBA
This session will provide an overview of current and proposed healthcare regulations and legislation and will discuss their impact on radiology, as well as RBMA's recent advocacy efforts on behalf of the industry. In addition, an explanation of various legislative and regulatory terminology will be presented. This session will also include a demonstration of formulas that attendees may use to calculate utilization revenue impact.
At the end of this session the learner should be able to:
- Explain the current and proposed healthcare regulations and their impact on the field of radiology.
- Describe the most recent RBMA advocacy activities.
- Hospitals and Radiologists: Perilous or Partnership? sponsored by
Patricia Kroken, FACMPE, CRA
In recent years, radiology practices have witnessed the unthinkable as groups with long-standing professional services agreements were terminated by their hospitals. What happened to the security of the exclusive contract? The session reviews several of the recent high-profile terminations as well as other lesser-known incidents and discusses what radiologists and managers need to learn from them, including suggestions on how to change the relationship from adversarial to "partner."
At the end of this session the learner should be able to:
- Assess case study examples of "when things go wrong."
- Identify industry trends facilitating turmoil.
- Explain how the hospital judges quality.
- Define proactive steps to change the paradigm in hospital/group relationships.
- Diagnostic Imaging – Stark and Fraud and Abuse Laws Affecting Diagnostic Imaging Facilities
Lisa Ohrin, Esq. and Andrew B. Wachler, Esq.
This session will provide an overview of the Stark and fraud and abuse laws that may affect (or prohibit altogether) financial arrangements between imaging providers and other healthcare providers. In addition, the speakers will identify problematic business arrangements that may trigger government review.
At the end of this session the learner should be able to:
- Explain the Stark and fraud and abuse laws that may impact financial arrangements between imaging providers and other healthcare providers.
- Describe problematic business arrangements and relationships that may trigger government review.
- Explain recent government enforcement activity that may impact participants' historical business practices.
- ACR Economics & Legislative Report (Repeated on Tuesday)
Ted Burnes, MPA and Maurine S. Dennis, MPH, MBA
This session will cover current economic issues and will identify future trends relating to payment policies. Topics will include payor interactions, coding, and the latest regulatory and legislative updates impacting imaging reimbursement.
At the end of this session the learner should be able to:
- Describe ACR's latest actions on Capitol Hill with respect to proposed Health System Reform Legislation.
- Explain Medicare's plans to implement further cuts and ACR's actions to minimize their impacts.
- Describe the legislative issues facing the field of radiology in 2010 and beyond.
- Basic Benchmarking: What New Managers Need to Know
Susan Cox, CPA
One of the most important tools a manager can use to manage a radiology practice or imaging center is benchmarking. In this session participants will learn what basic benchmarks should be monitored, what specific benchmarks tell about a practice or imaging center and how to compare results to industry standards.
At the end of this session the learner should be able to:
- Define the basic benchmarks all radiology managers should track.
- Distinguish what benchmark results tell a manager about a practice or imaging center.
- Demonstrate where to find industry standards for comparison.
3:15 pm – 4:15 pm
ROUNDTABLE SESSIONS
- Data
- Federal Affairs/Advocacy
- Imaging Center
- Hospital Based Practices
- New Manager Roundtable: HIPPA/Compliance
4:30 pm – 5:30 pm
CONCURRENT SESSIONS
- Point-Counterpoint: Payor Relations and Practice Profitability: An Oxymoron?
Rosemary Broderick, FACHE, Robert E. Gontarek and Ron Howrigon
Do you ever wonder about the payor's perspective regarding radiology business? Do the priorities of the health plan ever extend beyond managing unit costs, protecting and growing market share, and ensuring profitability for shareholders? Do customer service and patient satisfaction ever rank high on their priority list? And finally, how do these priorities impact radiology providers? Practices must rely on payors for reasonable reimbursements and are dependent on the payor relationship as a vital component of success and practice profitability. Find out how practices can achieve a better alignment in their partnership and connectivity with payors and more during this session.
At the end of the session the learner should be able to:
- Identify the importance of the payor as a priority in the success of a practice.
- Explain how practices can align and connect with payors.
- Nationwide Radiology - What Will it Take to Build a 1000 Radiologist Group Practice?
Gregory Q. Hill, JD, Mark Jensen, CPA, MBA, and Joseph P. White, CPA, MBA, CMPE
We have national accounting firms and law firms comprised of anywhere from 2,000 to 30,000 professionals. Will radiology groups evolve into "mega groups" of 500 to 1000 radiologists? This session will examine the key ingredients and factors that would allow growth, the barriers that would prevent growth and the benefits to radiologists.
At the end of the session the learner should be able to:
- Explain why radiology groups will continue to get bigger.
- Outline what will be required in order for groups to cover multiple regions.
- List the potential benefits to a national group.
- Diagnostic Imaging – A Comprehensive Approach: Anti-Markup Payment Limitations, IDTF Rules and Their Interplay with Stark and Fraud and Abuse Laws
Lisa Ohrin, Esq. and Andrew B. Wachler, Esq.
This session will provide a basic understanding of the anti-markup payment limitations that can affect imaging providers. Attendees will also gain an understanding of the importance of RAC and Medicaid Integrity Program audits of imaging providers, and will have an opportunity to participate in the analysis of several hypotheticals addressing the interplay of Stark, anti-kickback, anti-markup and IDTF regulations.
At the end of the session the learner should be able to:
- Explain the anti-markup payment limitations that can affect imaging providers.
- Outline important developments regarding IDTF rules.
- Explain the importance of RAC and Medicaid Integrity Program audits of imaging providers.
- Toxic Behaviors and Incivility in Healthcare: Research Indications
Elizabeth Holloway, PhD and Mitchell Kusy, PhD
This introductory session will present a national study of toxic behaviors and leaders' reactions in organizations and its relevance to the Joint Commission standards for professional civility. The devastating effects of cultures of toxicity on productivity, motivation, team collaboration, and staff retention will be described. In addition, the typical leaders' reactions to combat these effects and why they don't work will be discussed.
At the end of the session the learner should be able to:
- Identify toxic behaviors and typical leader reactions.
- Explain the bottom-line impact of toxic, disruptive behaviors.
- Describe the human impact of workplace incivility in healthcare.
- Illustrate why it's critical that healthcare deal with toxic behaviors and incivility.
Tuesday, May 25, 2010
8:30 am – 9:30 am
CONCURRENT SESSIONS
- Buy-In and Buy-Out Methods for Radiology Groups and Related Entities
Joseph P. White, CPA, MBA, CMPE
As radiology groups continue to increase in size and face decreased reimbursement changes how does this affect buy in and buy out methods? This session will examine current buy in/buy out strategies and the positive and negative impacts of each on a radiology group.
At the end of the session the learner should be able to:
- Define current common buy in and buy out methods used for professional groups.
- Explain current buy in and buy out methods for imaging centers.
- Review current buy in and buy out methods for real estate entities.
- Outline current buy in and buy out methods for related billing and management companies.
- Explore the benefits of different methods and explore the possible changes needed as groups become larger and face economic challenges.
- To Be Par or Non-Par, That is the Question: A Guide to Deciding Whether or Not to Participate with a Managed Care Plan
Ron Howrigon
The environment for medical practices and facilities has never been more turbulent and difficult. In the face of healthcare reform and Medicare cuts now more than ever groups need to make sure they are making the right business decisions. One key question for many practices and facilities is when they should participate with a managed care plan and when is it better to be non-par with a particular plan. In this session the presenter will examine this question and provide a blueprint for how groups and facilities can evaluate health plan contracts in order to decide which ones they should take and which ones are better left unsigned.
At the end of the session the learner should be able to:
- Evaluate payor contracts for both financial and nonfinancial considerations.
- Provide a description of various payor participation strategies.
- Implement the above tools in a practice.
- Building Successful Radiologist-Administrator Relationships: Advice from the Real World
Sean Bryant, MD, Philip Carmody, MD, Patricia Kroken, FACMPE, CRA and Kip McMillan
In today's fast-paced practice environment it is easy for administrators to sometimes clash with their physicians – and vice versa. If you are like most practice managers, you have had first-hand experience with the cultural and communication gaps that can lead to frustrations between physicians and administrators. How can you overcome these barriers to create a strong relationship based upon mutual trust? Attend this session to hear firsthand experiences from two radiologist-administrator teams who have done just that.
At the end of this session the learner should be able to:
- Outline potential situations that can lead to a breakdown in communication between physicians and administrators.
- Describe communication strategies for strengthening the physician-administrator relationship.
- Toxic Behaviors and Incivility in Healthcare: Practice Indications
Elizabeth Holloway, PhD and Mitchell Kusy, PhD
This session will focus on best practices for mitigating the effects of toxic behaviors and building workplace cultures of civility and respectful engagement. Intervention strategies that target large-scale, team, and individual levels of the organization will be presented.
At the end of this session the learner should be able to:
- Define a three-point systems approach to intervention.
- Identify strategies to intervene in:
- The larger system
- The team
- The individual
10:15 am – 12:00 pm
GENERAL SESSION
Re-Engineering Radiology in an Electronic and Flattened World: Radiologist as Value Innovator sponsored by 
Paul Chang, MD
Radiology practices have benefited from the adoption of electronic-based information technology, especially with respect to practice efficiency. However, these electronic tools are merely tools not solutions. In reality, installation of a picture archiving and communications system (PACS) or a speech recognition system will not fix a broken radiology practice. Increasingly, these same technologies are being used to commoditize and outsource radiology services. Unless we are willing to dramatically re-engineer our own attitudes and practices, we will not only fail to successfully leverage and exploit these advanced electronic tools, we will facilitate the perceived devaluation of radiology and participate in its marginalization and commoditization. Radiology practices must be value innovators that maximally leverage information technology to ensure its relevance and value to patient care.
At the end of this session the learner should be able to:
- Discuss how radiology must leverage and exploit the opportunities presented by the now inevitable transition to an electronic-based practice.
- Explain why radiology must address the ever-increasing expectations of patients and healthcare colleagues in the modern electronic-based information environment.
- Describe how and why radiology must redefine and re-engineer itself in order to fully take advantage of the electronic based practice.
- Outline the impact these changes in practice management can have on quality, workflow efficiency, and productivity.
- Define strategies to avoid marginalization and commoditization.
1:15 pm – 2:15 pm
ROUNDTABLE SESSIONS
- Hospital Based Practices
- Billing Services
- Imaging Centers
- Toxic Behaviors
- Teleradiology
3:00 pm – 4:00 pm
CONCURRENT SESSIONS
- Efficiently Dealing with Self Pay, Higher Deductibles and Health Savings Accounts
T. Scott Law, CPA and Taylor Moorehead
This session will focus on efficient ways to deal with the growing burden of increased patient responsibility including Health Savings Accounts and higher deductible plans. The methods discussed will include outbound dialers, IVR for incoming calls, web portal for payments and questions, and statement modifications.
At the end of this session the learner should be able to:
- Implement creative self pay campaigns via auto dialer.
- Explain auto dialers/web portals.
- Report to physicians regarding the effect of the above methods on the performance of collecting these dollars.
- Billing 101: What New Managers Need to Know
Christie James, MS
The quality of a billing process can make or break a radiology practice. A practice manager needs to understand the intricacies of billing functions and their impact on reimbursement: charge collection and input, coding, manual and EDS billing mechanics, A/R management…and that's just the beginning! This session is designed for managers who are new to the field of radiology and need to gain a better understanding of the basic components of the reimbursement cycle and the various components of billing for radiology services.
At the end of this session the learner should be able to:
- List the components of the reimbursement cycle.
- Explain the interrelationship of the various billing functions and their impact on each other.
- Minimizing the Impact of Rising Unemployment on Your Payor Mix and Self Pay Collections
Jeannette Gontarek, MBA and Greg Killinger
This session will evaluate the hidden impact of rising unemployment on the payor mix and the associated decline therein on self pay payments and revenue. The presentation will first provide audiences with a market analysis of local labor statistics and real anesthesia practice data to outline the impact of unemployment rates on rising self pay. The session will conclude with ideas on facility partnerships in order to implement new collection strategies, improve patient/insurance demographics received from facilities, and associate changes in the billing cycle for uninsured patients to minimize rising bad debt.
At the end of this session the learner should be able to:
- Illustrate how national economic conditions impact the business of medicine.
- Proactively identify trends and align them with patient billing cycles.
- Develop strategic plans in order to minimize negative impacts.
- ACR Economics & Legislative Report (Repeat of Monday session)
Ted Burnes, MPA and Maurine S. Dennis, MPH, MBA
This session will cover current economic issues and will identify future trends relating to payment policies. Topics will include payor interactions, coding, and the latest regulatory and legislative updates impacting imaging reimbursement.
At the end of this session the learner should be able to:
- Describe ACR's latest actions on Capitol Hill with respect to proposed Health System Reform Legislation.
- Explain Medicare's plans to implement further cuts and ACR's actions to minimize their impacts.
- Describe the legislative issues facing the field of radiology in 2010 and beyond.
Wednesday, May 26, 2010
8:30 am – 9:30 am
GENERAL SESSION
Changing Times: How Healthcare Reform will Impact Medical Imaging
Robert Maier, BS, CPA
Healthcare is undergoing a sea change in structure, reimbursement and delivery, partially due to Congress' efforts at reform and also in spite of it. Consumer directed healthcare, whether at the hands of payors or patients, is radically changing the dynamics of acute healthcare delivery and medical imaging. Congress and CMS have laid out a myriad of changes that will affect your service delivery and reimbursement for the next five years. All other major payors will have similar impact. Payors and RBMs are leading these changes by steering referring physicians and your patients to lower cost providers. The impact of these changes will have transforming effects on hospitals as well as freestanding and physician based services.
- How are proactive healthcare organizations preparing for this change?
- What are the key drivers to be aware of?
- How will competitors respond?
- How will our relationships with hospitals be affected?
- What resources will you need to remain competitive in this rapidly changing marketplace?
- Which strategies will be most effective to position your services for long term success?
At the end of this session the learner should be able to:
- Assess the changes that health reform is bringing to the market and how those changes will affect the traditional models of medical imaging delivery.
- Understand how medical imaging services will need to change to adapt and succeed in this new environment.
- Develop operational and market strategies and access to resources that will be necessary to position your organization to compete and succeed in the coming decade.
9:45 am – 10:45 am
CONCURRENT SESSIONS
- Radiology Practice Planning and Trend Analysis Key to Economic Success
Greg Killinger
Better billing and compliance techniques aren't enough to assure success among today's radiology practices. This session will address how practices can identify and pursue new revenue opportunities through improved planning strategies. Practice managers and administrators will learn to analyze trends and create projections to make better financial decisions regarding new business opportunities. New approaches to gathering information and industry data will also be presented in order to improve decision processes for new business opportunities. Importantly, they will garner planning and analysis skills to consistently boost revenue.
At the end of this session the learner should be able to:
- Identify, pursue, secure and expand new practice revenue opportunities by analyzing various planning methods that meet individual practice needs.
- Create strategic planning models for new business presentations.
- Gather data and trend information with greater insight and efficiency.
- Optimize physician time to allow more focus on business strategy, planning and direction.
- Project financial outcomes based on enhanced research methods and data gathering.
- Denials Management: A Case Study
Patricia Kroken, FACMPE, CRA and Jennifer Kroken, MBA
A sub-specialty radiology practice in Dallas, Texas has run a sophisticated denials management program for approximately five years. This session covers how the program was set up, how denial types were prioritized for follow-up and corrected, and the results achieved to date. It also explains what the concept of denials management is – and is not.
At the end of this session the learner should be able to:
- Articulate how to set up a denials management program.
- Explain how Six Sigma provides a discipline for setting priorities and work through the process.
- Describe the role of technology in denials management.
- Illustrate examples of how certain types of denials were reduced and managed.
- Outline where denials management can go from here.
- Project Management for the New Manager – Your GPS for Success
Laura Martin Davis, CNMT, MBA
This session is an overview of project management including the major process steps, identifying different aspects of a project, must-haves, and tools that will help ease the journey. The session content is intended for those managers who are new to management, or mid-level managers who have somehow missed out on the joys of managing projects!
At the end of this session the learner should be able to:
- Define project management.
- Identify the major process steps of project management and the tools available.
11:00 am – 12:00 pm
CONCURRENT SESSIONS
- Radiology Resources for New Practice Managers
Lori Shore, BS, CPC, RCC
This session will provide tips and tools for those new to the industry, especially those who did not come from a medical background. The course will explore some of the many radiology acronyms and offer ways to keep up with the latest; introduce attendees to the basics of medical terminology, coding guidelines by modality and modifiers.
At the end of this session the learner should be able to:
- Identify industry acronyms and resources to assist with maintaining current knowledge.
- Define prefixes, combining forms and suffixes and break down medical terms into more understandable components.
- Explain the basics of radiology modalities.
- Brave New World: Will Your Radiology Group Be Ready for RACs?
Edward R. Gaines III, JD, CCP
With losses of $11 billion in 2007 from improper payments, the Centers for Medicare & Medicaid Services (CMS) has now introduced an aggressive new program – the Recovery Audit Contractors Program (RACs) – designed to root out fraud, waste and abuse at virtually every level. This session will target radiology provider organizations and describe RACs in great detail. Audiences will take away essential information on how to prepare for the changes – including self assessment to gauge vulnerability and risks, and appeals strategies to reduce potential financial exposure and repeat investigations.
At the end of this session the learner should be able to:
- Develop successful RACs response strategies for the program rollout.
- Identify and mitigate potential problem areas involving coding accuracy and medical necessity compliance.
- Conduct self-assessments in order to gauge areas of potential vulnerability.
- Conduct internal "outlier" analysis before a RAC audit letter is received.
- Create and implement policies to ensure that all inquiries from RAC contractors are immediately acknowledged and addressed.
- Reduce or eliminate risks, based on self-assessment strategies put in place.
- CMS Accreditation Requirements Under the Medicare Improvements for Patients and Providers Act (MIPPA)
Leonard Lucey, JD, LLM
This session will explain in detail the new CMS accreditation requirements for diagnostic imaging under the MIPPA legislation. The session will also explain how these new requirements differ from and impact current ACR accreditation requirements.
At the conclusion of this session the learner should be able to:
- Identify and understand the new CMS diagnostic imaging accreditation requirements that become effective January 1, 2012.
- Explain how the CMS requirements differ from current ACR imaging accreditation requirements.
- Outline how to prepare for CMS accreditation.
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