The ACR Proactively Works to Improve the Physician Practice.
Full-Day Course on Practice Management
The ACR launched a full-day pre-meeting course at the 2012 ACR/ARHP Annual Meeting focused directly on practice management. Practice managers and physicians across the United States attended this new course to learn how to grow and improve rheumatology practices. This course will be offered again in 2013 using the input from first-time attendees to build on its success.
Other Practice Management Education
ACR staff delivered 12 coding, audit, insurance, government affairs and certification presentations at Affiliate State Society meetings throughout 2012, which are free to schedule for ASC members. The ACR also provides presentations in local areas for at least 10 people for a nominal fee. These presentations allow ACR’s expert staff to educate on a practice-by-practice basis, and also learn about issues in local areas.
The ARHP Practice Committee updated online educational content and resources such as biologics reference guides, evidence-based content, Fracture Risk Assessment, and physical therapy tools. The committee also reviewed and updated the briefing papers for health professionals in rheumatology. The committee contributed articles to The Rheumatologist on “Medication Quick Guides” (June), “Role of the Social Worker in the Management of Rheumatic Disease” (July), “Role of Social Media in Rheumatology Practice” (September), and “Occupational Therapy and Hand Therapy Treatment of Osteoarthritis” (November).
Coding education was increased s through the certified rheumatology coding course. The rheumatology coding certification allows rheumatology practice staff to acquire the skills needed to claim every appropriate dollar per patient visit. The Certified Rheumatology Coder™ specialty credential demonstrates a superior level of coding expertise in the field of rheumatology and validates a person's ability to assign the correct codes.
Creation of New CPT Codes
In 2012, the ACR along with 15 other specialty societies created transitional care management codes to report non face-to-face care management services that require moderate or high complexity medical decision making during transitions from an inpatient hospital setting to home or a nursing facility –furnished by the physician or qualified non-physician practitioner. The TCM codes were accepted in the Final Rule with a work Relative Value Unit of 3.05, which was a great success for the multiple specialty workgroup as the Centers for Medicare & Medicaid Services proposed a work RVU of 1.28 for these codes.
The workgroup also created the complex chronic care coordination codes to report care management and support services provided by physicians and other qualified health care professionals to an individual who resides at home, a skilled nursing facility or other assisted living facility. The specialty societies continue to work with CMS on the vignettes to submit the CCC codes for valuation in 2013.
Building Relationships with Health Plans
The ACR worked diligently in 2012 on numerous insurance issues affecting rheumatology practices nationwide and worked with various patient groups, such as the Arthritis Foundation, to send letters to insurance companies. The ACR continues to advocate for members on this front through the Insurance Subcommittee in an effort to minimize administrative burdens. The ISC forged relationships with medical directors from United Healthcare, CVS Caremark, WellPoint, Aetna and Humana in an effort to bring awareness to issues affecting the rheumatology community. The committee also reviewed several draft policies and provided input on how they will affect rheumatologists. The ACR will continue to work with insurance companies to provide reliable information on draft medical policies; appropriate information on policy and program development; and, a mechanism to understand issues relating to rheumatic disease.
ACR Position Statements Updated
In 2012, the ACR updated the following position statements:
Additionally, the ACR once again updated the Model Biologics Policy and split the paper into two sections: access and indications. The ACR continues to encourage insurance companies to follow the Model Biologics Policy.
Continuing the Health Policy Conversation
As in previous years, the ACR was present at important coding and health policy meetings to ensure that rheumatology issues were appropriately addressed. These meetings include American Medical Association, CPT, RUC, ACP Council of Subspecialty Societies, ACP Subspecialty Advisory Group on Socioeconomic Affairs, and AMA House of Delegates meetings.
Timothy Laing, MD is completing his term on the internal medicine rotating seat. Eileen Moynihan, MD was elected to serve as the AMA RUC alternate seat. Dr. Moynihan will serve as the alternate for three years.
Additionally, the ACR went through the American Medical Association’s five-year review and was successful in meeting the requirements including having 1,000 ACR members join the AMA. This will allow the ACR to retain membership and have a voice for rheumatology in the AMA Federation, the RUC and CPT process.