Report of the American Board of Radiology James P. Borgstede, M.D., FACR President-Elect

1. Report of the American Board of RadiologyJames P. Borgstede, M.D., FACRPresident-Elect

2. ABR efforts on behalf of our diplomates • ABR of the future • ABMS of the future • Integration of ABR within healthcare and healthcare regulatory bodies

3. Thanks • Gary Becker and ABR staff • David Laszakovits • Jennifer Bosma • My ABR Trustee Colleagues

4. Mission of the American Board of Radiology “To serve patients, the public, and the medical profession. . .” “. . .by certifying that its diplomates have acquired, demonstrated, and maintained a requisite standard of knowledge, skill, and understanding. . .”

5. New ABR Endeavors To Assist Diplomates The ABR is must demonstrate accountability to its diplomates. Without them the ABR cannot implement its mission. Relevance of ABMS/ABR certification must be demonstrated to the public, payers, and the government. Medicine is experiencing a fusion of economics, quality, safety, and reimbursement so our organizations must work together to effectively project and promote our specialty for the benefit of our patients. Accountability and transparency remain the watchwords for the new millennium.

6. New ABR Endeavors To Assist Diplomates • Facile Maintenance of Certification (MOC) • Value enhanced MOC with private carriers to optimize its benefits. • Group and institutional MOC • Advocacy for our diplomates to ABMS for recognition of focused practice in cardiac CT in conjunction with ACR • ABR advisory committees • Exam centers in Chicago and Tucson

7. New ABR Endeavors To Assist Diplomates • Alignment of ABR processes with other aspects of our diplomates’ radiology practices • Affordable Care Act and payment reform • e.g. ABR has been given provisional CMS authorization to report MOCP participation as allowed by authorized ABMS boards • Credentialing requirements • Maintenance of Licensure with state medical boards

8. A New ABR Primary Certificate • ABR currently offers 3 primary certificates: Diagnostic Radiology, Radiation Oncology, and Medical Physics • Primary Certificate in Interventional and Diagnostic Radiology would be a 4th and the ABR is seeking approval from ABMS • Will not be a separate stand alone primary VIR certificate • Will allow radiology to favorably compete with surgery programs in vascular interventional training while keeping this training and skill within the house of radiology • ABR is responding to request of its diplomates. • ABR supports the ACR resolution and appreciates ACR support of this effort.

9. Dual Certificate in IR and DR • The IR/DR Dual Certificate positions the ABR as the home of image-guided interventions within medicine and solidifies the link to Diagnostic Radiology competency. • This will be an additional integrated training option resulting in identical procedural competencies as the VIR CAQ; the ABR will continue to support the VIR CAQ.

10. The ABR of the Future • Increased demands to demonstrate relevance of certification • Increasing expectations of accountability to our diplomates • ABR has established advisory committees • Increased demands from a more robust American Board of Medical Specialties (ABMS)

11. More robust More legislatively active Continuous MOC rather than 10 year cycles Involvement and promotion of institutional MOC Significant presence of primary care boards in ABMS governance Competition from rogue organizations for stature ABMS of the Future

12. Integration of the ABRwithin healthcare and healthcare regulatory bodies

13. TRADITIONAL ACCOUNTABILITY FRAMEWORK Specialty Board Certification PrivateNot-for-Profits Quality Organizations State Medical Licensure

14. EVOLVING ACCOUNTABILITY FRAMEWORK Certification MOC PrivateNot-for-Profits Quality Organizations MOL

15. An Example

16. Participation in the Centers for Medicare and Medicaid Services (CMS) Physician Quality Reporting System (PQRS) for a 1% annual bonus payment to each qualifying physician on all Medicare services they bill. This program is not the same as ABR/ABMS practice quality improvement projects required for ABR/ABMS maintenance of certification. • But if PQRS, then the opportunity for an additional 0.5% bonus from CMS for participating in the Maintenance of Certification Program (MOCP) operated by an ABMS specialty board (ABR) for CMS through the Affordable Care Act. This is where the ABR and ABMS enter the picture • Therefore, physicians already participating in MOC to maintain their ABR certificate can leverage that participation for a 0.5% bonus.

17. MOCP Mechanics • ABMS board e.g. ABR has received provisional approval from CMS as the “submitter of data” for ABR diplomates to fulfill both part 4 of MOC for ABR recertification and qualification for MOCP reimbursement under the ACA. • ABR MOC participants will be eligible for the additional 0.5% incentive IF: • They have met the PQRS requirements • They have “successfully completed a qualified MOC Program practice assessment for 2011” • This is the only pathway by which the MOC PQRS incentive may be obtained. • While these small economic percentages may not seem significant now, they will soon turn into a penalty with a much greater significance.

18. Areas of ABR/ACR Synergism • Focused practice in cardiac CT with examination at the ACR education center • ABR interface with ACR education center • ACR leadership in registry development

20. Mission of the American Board of Radiology “To serve patients, the public, and the medical profession. . .” “. . .by certifying that its diplomates have acquired, demonstrated, and maintained a requisite standard of knowledge, skill, and understanding. . .”