#JACR Transcript

Healthcare social media transcript of the #JACR hashtag.
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PF Anderson @pfanderson@disabled.social @pfanderson
RT @radiologydraws: A little behind the scenes shot before we go live for the #JACR tweet chat https://t.co/ztCloSUHtU
PF Anderson @pfanderson@disabled.social @pfanderson
RT @JACRJournal: We Kick of the #JACR tweet chat today with a live point counter-point discussion with Zeke Silva, MD and Alan Kaye, MD. Broadcasting live in 5mins. Catch the broadcast on our youtube at https://t.co/4zqAyGy0M4
JACR @JACRJournal
Welcome to the #JACR Tweet Chat on Payer steerage of imaging care . Today is a little different we start off with a live point counter point on youtube. Watch the live discussion here: https://t.co/4zqAyGy0M4 https://t.co/yA4niHNdRT
JACR @JACRJournal
And we’re live! https://t.co/3WnXdHnS6G the point counter point has begun #jacr
JACR @JACRJournal
Jump over to YouTube to hear both points https://t.co/3WnXdHnS6G #JACR
PF Anderson @pfanderson@disabled.social @pfanderson
RT @JACRJournal: Jump over to YouTube to hear both points https://t.co/3WnXdHnS6G #JACR
PF Anderson @pfanderson@disabled.social @pfanderson
RT @JACRJournal: And we’re live! https://t.co/3WnXdHnS6G the point counter point has begun #jacr
PF Anderson @pfanderson@disabled.social @pfanderson
RT @JACRJournal: Welcome to the #JACR Tweet Chat on Payer steerage of imaging care . Today is a little different we start off with a live point counter point on youtube. Watch the live discussion here: https://t.co/4zqAyGy0M4 https://t.co/yA4niHNdRT
JACR @JACRJournal
@pfanderson Dr Silva is presenting his point right now, Dr Kaye will be back to retort shortly #JACR
PF Anderson @pfanderson@disabled.social @pfanderson
Puzzled by today's #jacr chat. What is appropriate way to engage? Audio problems with the live feed for one of the speakers. Are there supporting materials? Definition of terms? Scope of questions?
Jenny Jones @Jenny_Writer
RT @JACRJournal: Jump over to YouTube to hear both points https://t.co/3WnXdHnS6G #JACR
American College of Radiology @RadiologyACR
RT @JACRJournal: Welcome to the #JACR Tweet Chat on Payer steerage of imaging care . Today is a little different we start off with a live point counter point on youtube. Watch the live discussion here: https://t.co/4zqAyGy0M4 https://t.co/yA4niHNdRT
AuntMinnie.com @AuntMinnie
RT @JACRJournal: And we’re live! https://t.co/3WnXdHnS6G the point counter point has begun #jacr
AuntMinnie.com @AuntMinnie
RT @JACRJournal: Jump over to YouTube to hear both points https://t.co/3WnXdHnS6G #JACR
PF Anderson @pfanderson@disabled.social @pfanderson
@JACRJournal Thanks. There was NO audio for Dr. Kaye at the beginning. Need a mic test, audience audio test. #jacr
PF Anderson @pfanderson@disabled.social @pfanderson
RT @JACRJournal: When describing the number of lesions, make sure everyone agrees what "few," "several," and "multiple" actually mean #JACR https://t.co/pbdNhzbv5H https://t.co/BjQVUZvKpR
Nicole Racadag @NRacadag
RT @radiologydraws: A little behind the scenes shot before we go live for the #JACR tweet chat https://t.co/ztCloSUHtU
Nicole Racadag @NRacadag
RT @JACRJournal: We Kick of the #JACR tweet chat today with a live point counter-point discussion with Zeke Silva, MD and Alan Kaye, MD. Broadcasting live in 5mins. Catch the broadcast on our youtube at https://t.co/4zqAyGy0M4
JACR @JACRJournal
Let's get started with the #JACR Tweet Chat T1: Put yourself in the role of a patient. What are your reactions to steerage and why? Does that change if you receive an incentive to use a certain provider? #JACR https://t.co/Lb4bUbXFtn
JACR @JACRJournal
The Live Broadcast is over we now turn to our regular tweet chat format. Which Point did you agree with? #JACR
Seth M Hardy, MD MBA @sethmhardy
Patients are generally not well informed in regards to quality. Cost in the denominator is about their only value metric. #JACR
JACR @JACRJournal
Who's Joining us today for the #JACR tweet chat? introduce yourselves
JACR @JACRJournal
RT @sethmhardy: Patients are generally not well informed in regards to quality. Cost in the denominator is about their only value metric. #JACR
Seth M Hardy, MD MBA @sethmhardy
Neither, but the both did well and I appreciate their efforts. #JACR
Zeke Silva @zekesilva3
@sethmhardy #JACR: T1: The quality piece is huge - any steerage policy has to consider the quality of the center to which patients are referred
Seth M Hardy, MD MBA @sethmhardy
From central PA. #JACR
Seth M Hardy, MD MBA @sethmhardy
I don’t disagree but how? It is extremely difficult to measure, especially when we do accredit crappy old magnets. #JACR
PF Anderson @pfanderson@disabled.social @pfanderson
RT @JACRJournal: Let's get started with the #JACR Tweet Chat T1: Let's get started with the #JACR Tweet Chat T1: Put yourself in the role of a patient. What are your reactions to steerage and why? Does that change if you receive an incentive to use a certain provider? #JACR https://t.co/Lb4bUbXFtn
Zeke Silva @zekesilva3
@sethmhardy #JACR T1: It is a fair point: patients rightfully assume the place they are sent is quality. If that proves to not be the case, by whatever metric, then the system has not done its job
JACR @JACRJournal
RT @zekesilva3: @sethmhardy #JACR: T1: @sethmhardy #JACR: T1: The quality piece is huge - any steerage policy has to consider the quality of the center to which patients are referred
PF Anderson @pfanderson@disabled.social @pfanderson
@JACRJournal "When payors try to directly influence the patient’s or treating physician’s choice of imaging provider, this strategy is typically referred to as “steerage.”" https://t.co/tzrks1xcdS #jacr
PF Anderson @pfanderson@disabled.social @pfanderson
RT @sethmhardy: Patients are generally not well informed in regards to quality. Cost in the denominator is about their only value metric. #JACR
JACR @JACRJournal
T2: Put yourself in the role of a referring physician. What are your reactions to steerage and why? Does that change if you are incentivized to use affiliated imaging provider? #JACR https://t.co/Ztd1otHfxu
PF Anderson @pfanderson@disabled.social @pfanderson
Patient Steerage Could Harm Radiologists, Confuse Patients https://t.co/qC0Oz1N6Ki #jacr
PF Anderson @pfanderson@disabled.social @pfanderson
RT @zekesilva3: @sethmhardy #JACR T1: It is a fair point: @sethmhardy #JACR T1: It is a fair point: patients rightfully assume the place they are sent is quality. If that proves to not be the case, by whatever metric, then the system has not done its job
Seth M Hardy, MD MBA @sethmhardy
I’ll share in the Lancaster market the hospital has kept a beautiful new short bore 1.5T OPT magnet idle bc they didn’t want to cannibalize their legacy grandfathered low field magnet. Unacceptable!!! #JACR
PF Anderson @pfanderson@disabled.social @pfanderson
J Am Coll Radiol. 2005 Oct;2(10):846-9; discussion 850-1. Negotiating in a managed care world. https://t.co/zyiyNjqSNA #steerage #jacr
PF Anderson @pfanderson@disabled.social @pfanderson
RT @sethmhardy: I’ll share in the Lancaster market the hospital has kept a beautiful new short bore 1.5T OPT magnet idle bc they didn’t want to cannibalize their legacy grandfathered low field magnet. Unacceptable!!! #JACR
Zeke Silva @zekesilva3
#JACR T2: Indeed - patients should be informed of the consequences of steerage, so an educated, team-based, decision can be made. I hear often that referring physicians feel their credibility is undermined by a pre-auth program
Seth M Hardy, MD MBA @sethmhardy
Referrers are not going to jeopardize their employment over this issue. #JACR
Brett Hansen @RadiologyAlly
As a #patient, or #physician What do you think of incentives used by payers to steer patients to see a specific doctor? To be inpatients, vs. outpatients? #jacr #steerage
JACR @JACRJournal
We're midway through our discussion questions on "Payer Steerage of Imaging Care" What #thursdayThoughts do you have to add? join the conversation with #JACR tweet chat.
JACR @JACRJournal
RT @zekesilva3: #JACR T2: #JACR T2: Indeed - patients should be informed of the consequences of steerage, so an educated, team-based, decision can be made. I hear often that referring physicians feel their credibility is undermined by a pre-auth program
PF Anderson @pfanderson@disabled.social @pfanderson
RT @zekesilva3: #JACR T2: #JACR T2: Indeed - patients should be informed of the consequences of steerage, so an educated, team-based, decision can be made. I hear often that referring physicians feel their credibility is undermined by a pre-auth program
PF Anderson @pfanderson@disabled.social @pfanderson
RT @sethmhardy: Referrers are not going to jeopardize their employment over this issue. #JACR
Seth M Hardy, MD MBA @sethmhardy
Pre auth is really a separate issue. That is more about appropriateness? What we are talking about today is all about money. Pure and simple. #JACR
4ak @4ak17
@JACRJournal #jacr Ref docs tell me they are conflicted when they have to send patients to high priced facilities when they know of quality, lower priced alternatives. A few anecdotal instances in my community tha5 they have lost patients because they did so.
JACR @JACRJournal
RT @4ak17: @JACRJournal #jacr Ref docs tell me they are conflicted when they have to send patients to high priced facilities when they know of quality, lower priced alternatives. A few anecdotal instances in my community tha5 they have lost patients because they did so.
Seth M Hardy, MD MBA @sethmhardy
#JACR
PF Anderson @pfanderson@disabled.social @pfanderson
RT @4ak17: @JACRJournal #jacr Ref docs tell me they are conflicted when they have to send patients to high priced facilities when they know of quality, lower priced alternatives. A few anecdotal instances in my community tha5 they have lost patients because they did so.
Zeke Silva @zekesilva3
#JACR T2: Another great point. But, if a referring doc wants his/her patient to go to a radiologist they trust, and a third party over-rides that, the referring doc may feel slighted
JACR @JACRJournal
#JACR
JACR @JACRJournal
RT @zekesilva3: #JACR T2: #JACR T2: Another great point. But, if a referring doc wants his/her patient to go to a radiologist they trust, and a third party over-rides that, the referring doc may feel slighted
Brett Hansen @RadiologyAlly
#ThursdayThoughts: As a #patient, or #physician What do you think of incentives used by payers to steer patients to see a specific doctor? To be inpatients, vs. outpatients? To see someone who's cheaper but not necessarily better? #jacr #steerage #jacr https://t.co/XdDVaug9P2
JACR @JACRJournal
T3: Put yourself in the role of a practicing radiologist. How do you justify a position for or against steerage? #JACR https://t.co/PeCxM9mueW
Seth M Hardy, MD MBA @sethmhardy
Then perhaps that trusted rad needs to look at their pricing structure. Cost is one of 4 operational pillars. Timeliness, quality, flexibility being the others. #JACR
4ak @4ak17
@zekesilva3 #JACR Docs also do not like being told where to send patients or having them blocked by doing so by their EMR.
Zeke Silva @zekesilva3
#JACR And cost is one of the performance categories under MACRA, so all of our responsibility to understand it better. And assume responsibility for it
Seth M Hardy, MD MBA @sethmhardy
I’m agnostic. The price differentials driving these decisions will eventually equalize. We need to make sure that we don’t alienate anyone in the meantime. #JACR
4ak @4ak17
#JACR how do u feel about making patient bear a higher copay if they want to go to a high priced facility?
Seth M Hardy, MD MBA @sethmhardy
RT @zekesilva3: #JACR And cost is one of the performance categories under MACRA, so all of our responsibility to understand it better. And assume responsibility for it
Rich Heller @reh3md
T3: An argument against economic steerage: Different sites provide different levels of service (ie sub-sub-specialty coverage, like pediatric neuroradiology). #jacr
Rich Heller @reh3md
RT @zekesilva3: #JACR T2: #JACR T2: Another great point. But, if a referring doc wants his/her patient to go to a radiologist they trust, and a third party over-rides that, the referring doc may feel slighted
Zeke Silva @zekesilva3
So everyone knows: 4ak is Dr. Kaye #pastACRpresident #JACR
Seth M Hardy, MD MBA @sethmhardy
@4ak17 It sucks, but it is reality today. Copays were made to change behavior and there are trade offs. #JACR
Zeke Silva @zekesilva3
#JACR Such an important point: communities are different - local matters. National policies, by definition, can not account for those differences
JACR @JACRJournal
RT @zekesilva3: So everyone knows: So everyone knows: 4ak is Dr. Kaye #pastACRpresident #JACR
JACR @JACRJournal
RT @reh3md: T3: An argument against economic steerage: T3: An argument against economic steerage: Different sites provide different levels of service (ie sub-sub-specialty coverage, like pediatric neuroradiology). #jacr
PF Anderson @pfanderson@disabled.social @pfanderson
RT @sethmhardy: Pre auth is really a separate issue. That is more about appropriateness? What we are talking about today is all about money. Pure and simple. #JACR
JACR @JACRJournal
RT @zekesilva3: #JACR Such an important point: #JACR Such an important point: communities are different - local matters. National policies, by definition, can not account for those differences
PF Anderson @pfanderson@disabled.social @pfanderson
RT @reh3md: T3: An argument against economic steerage: T3: An argument against economic steerage: Different sites provide different levels of service (ie sub-sub-specialty coverage, like pediatric neuroradiology). #jacr
Seth M Hardy, MD MBA @sethmhardy
Agree, and those organizations need to differentiate themselves strategically. If I have a really sick kid, I’m not taking them to a podunk hospital. 🤞🏼 #JACR
PF Anderson @pfanderson@disabled.social @pfanderson
RT @zekesilva3: So everyone knows: So everyone knows: 4ak is Dr. Kaye #pastACRpresident #JACR
4ak @4ak17
@sethmhardy #jacr Let me clarify. Rather than not covering high cost centers, let patient know that they will have higher copays to go to higher cos centers.
JACR @JACRJournal
RT @4ak17: @sethmhardy #jacr Let me clarify. Rather than not covering high cost centers, let patient know that they will have higher copays to go to higher cos centers.
Brett Hansen @RadiologyAlly
As a #patient, I'm already ingrained to be steered. "Will they take my insurance?" is my #1 question. My #2 question is asking friends/coworkers if they've had a good/bad experience. Cost of the provider doesn't even enter the equation if I'm paying the same copay #jacr
JACR @JACRJournal
T4: Are different payments to different sites of service appropriate? For example, is it appropriate to pay hospitals more? If so, how much of a premium is acceptable? #JACR https://t.co/rJaF7oI99T
Seth M Hardy, MD MBA @sethmhardy
@4ak17 Sure, some will recognize that value and be willing to pay for it. Recognizing that this would worsen social determinants of health. #JACR
Zeke Silva @zekesilva3
#JACR T4: Well, the hospitals would likely argue that they incur more expense in providing their services
Brett Hansen @RadiologyAlly
RT @JACRJournal: T4: T4: Are different payments to different sites of service appropriate? For example, is it appropriate to pay hospitals more? If so, how much of a premium is acceptable? #JACR https://t.co/rJaF7oI99T
Seth M Hardy, MD MBA @sethmhardy
I think it is a moot question. Our B2B customers, the payers, are going to send the walking wounded to lower cost centers. They don’t care about another’s overhead, only their own. This isn’t socialism. #JACR
Rich Heller @reh3md
T4: If you believe that all radiology sites are equal, then site neutral payments make more sense. But that’s just not reality. #jacr
4ak @4ak17
#JACR That assumes there is a different outcome. Also, a $3000 MRI would change the economic health of many people: stress, unhealthy food vs Mediterranean diet.....
JACR @JACRJournal
Thanks for joining the #JACR tweet chat today, any final thoughts?
Sandeep Arora @LetDdiceFlyHigh
RT @reh3md: T4: T4: If you believe that all radiology sites are equal, then site neutral payments make more sense. But that’s just not reality. #jacr
Seth M Hardy, MD MBA @sethmhardy
In fact we have #JACR proof they do. However look at it strategically from @AnthemInc side, they are trying to survive by keeping costs down and pass that on to their customers. No more, no less.
Zeke Silva @zekesilva3
#JACR To be fair, the payors have crafted many exceptions to the steerage policy we are discussing, such as pedi, OB patient, chronic condition...oh, and milage
Valerie Hawkins @librariesval
RT @zekesilva3: So everyone knows: So everyone knows: 4ak is Dr. Kaye #pastACRpresident #JACR
Sandeep Arora @LetDdiceFlyHigh
RT @zekesilva3: #JACR T2: #JACR T2: Another great point. But, if a referring doc wants his/her patient to go to a radiologist they trust, and a third party over-rides that, the referring doc may feel slighted
4ak @4ak17
@sethmhardy #JACR Right on. It is only a matter of time. But I see that hospitals are holding on to their high fees, while at the same chanting the value-based care mantra.
Rich Heller @reh3md
@sethmhardy Then the customers (insurance subscribers) can vote with their feet by patronage of products that support their needs. A big deal in the peds world. #jacr #InNetworkChildrensHospital
Seth M Hardy, MD MBA @sethmhardy
No it isn’t reality, but costs are the easiest process metric to measure. #JACR
Zeke Silva @zekesilva3
#JACR Great perspectives today on the complicated topic of steerage with no easy answers. Collaboration is key
Seth M Hardy, MD MBA @sethmhardy
@reh3md Yes, and we see that in some markets like Pittsburgh. #JACR
JACR @JACRJournal
RT @zekesilva3: #JACR Great perspectives today on the complicated topic of steerage with no easy answers. Collaboration is key
Seth M Hardy, MD MBA @sethmhardy
The most important goal we should be striving for is to keep the membership together while serving the ACR mission and our patients. #JACR
Seth M Hardy, MD MBA @sethmhardy
RT @zekesilva3: #JACR Great perspectives today on the complicated topic of steerage with no easy answers. Collaboration is key
Rich Heller @reh3md
The great thing about tweet chats like this is that w/ scholars like @zekesilva3 @RadiologyBoy1 @sethmhardy& others, I learn so much. And fun to interact. Great job! @JACRJournal #jacr
Rich Heller @reh3md
RT @sethmhardy: The most important goal we should be striving for is to keep the membership together while serving the ACR mission and our patients. #JACR
Syed Furqan Zaidi, MD, MBA, FACR @zaidirad
RT @sethmhardy: The most important goal we should be striving for is to keep the membership together while serving the ACR mission and our patients. #JACR
JACR @JACRJournal
RT @reh3md: The great thing about tweet chats like this is that w/ scholars like @zekesilva3 @RadiologyBoy1 @sethmhardy& others, I learn so much. And fun to interact. Great job! @JACRJournal #jacr
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