The second annual ACR Division Directors’ Conference took place in Chicago on March 10–11. The conference opened with a presentation on the use of the ACR’s Rheumatology Informatics System for Effectiveness (RISE) Registry in academic medical centers by Salahuddin “Dino” Kazi, MD, from UT Southwestern Medical Center, and Jinoos Yazdany, MD, MPH, from the University of California San Francisco. Dr. Kazi reviewed the mechanics of the registry and how it is designed to retrieve relevant medical data from electronic medical record systems without the need for significant clinician involvement. A number of community physicians have enrolled in RISE, but many implementation barriers remain for academic medical centers, which the committee is currently addressing. Dr. Yazdany emphasized how this registry can be used to improve quality of care in clinical rheumatology practice and may serve as an important resource for rheumatology fellow quality projects.
Daniel F. Battafarano, DO, from the San Antonio Medical Military Center, presented highlights from the 2015 ACR Workforce Study.
The education of fellows in rheumatology was presented by Douglas W. White, MD, PhD, chair of the ACR’s Committee on Rheumatologic Care, and Maria I. Danila, MD, MSc, MSPH, a rheumatologist at the University of Alabama at Birmingham (UAB). Dr. White presented data from a survey completed by rheumatology fellows, the majority of whom thought it was important to teach the business of rheumatology during fellowship, but not in the first year. The fellows expressed support for interaction with community clinicians and administrators familiar with billing procedures and best practices in the rheumatology setting. Dr. Danila discussed how UAB prepares fellows to enter rheumatology practice with educational sessions on contract negotiation, finance, clinic work flow, human resource management and marketing.
Angus Worthing, MD, chair of the ACR’s Government Affairs Committee, discussed ACR advocacy strategies and Congressional healthcare reform efforts. He also reviewed the two pathways, Merit-Based Incentive Payment System and Alternate Payment Models, that are available under MACRA. He addressed the key rheumatology issues related to MACRA, including the reduction in cost-attribution risk, the potential importance of the RISE Registry for clinical practice improvement and development of quality measures, along with opportunities for rheumatologists to comment on rule updates. He also mentioned workforce issues and the importance of RheumPAC for building relationships with members of Congress.
Lilly Marks, vice president for health affairs at the University of Colorado, discussed medical school economics and the many challenges facing the academic mission. She emphasized that understanding the risks, rewards and nuances of leverage is critical to understanding the financial aspects of academic medicine. Medical schools have successfully built and financed their missions through leveraging of primary revenue sources derived largely from clinical income, which has grown precipitously over the past 20 years.