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The mission of the Harvey L. Neiman Health Policy Institute® is to establish foundational evidence for health policy and radiology practice that promotes the effective and efficient use of health care resources and improves patient care.

Access & Quality

August 14, 2023

Does Sex-based Disparity Exist in Neuroimaging, and How Does It Affect Patient Outcomes?

Gender-Based Disparity in Acute Stroke Imaging Utilization and the Impact on Treatment and Outcomes: 2012 to 2021. Read the JACR study for full details.

Trends in Diagnostic Imaging by Nonphysician Practitioners and Associations With Urbanicity and Scope-of-Practice Authority

We aimed to assess the changing share of diagnostic imaging billed by NPPs and how such changes differ by urbanicity within the context of scope-of-practice regulations and legislation. Full Article

Casey E. Pelzl MPH, Elizabeth Y. Rula PhD, Richard Duszak Jr MD, Eric W. Christensen PhD. 2023. "Trends in Diagnostic Imaging by Nonphysician Practitioners and Associations With Urbanicity and Scope-of-Practice Authority," Current Problems in Diagnostic Radiology

Comparison of Lung Cancer Screening Eligibility and Use between Commercial, Medicare, and Medicare Advantage Enrollees

Lung cancer screening does not require patient cost-sharing for insured people in the U.S. Little is known about whether other factors associated with patient selection into different insurance plans affect screening rates. We examined screening rates for enrollees in commercial, Medicare Fee-for-Service (FFS), and Medicare Advantage plans. Considerable variation exists in lung cancer screening between different payers and across patient characteristics. Efforts targeting historically vulnerable populations could present opportunities to increase screening. Full Article

Danny R. Hughes, PhD; Jie Chen, PhD; Alexandra E. Wallace, MS; Shubhsri Rajendra, MS; Stefan Santavicca, MS; Richard Duszak Jr., MD; Elizabeth Y. Rula, PhD; Robert A. Smith, PhD. 2023. "Comparison of Lung Cancer Screening Eligibility and Use between Commercial, Medicare, and Medicare Advantage Enrollees," Journal of American College of Radiology (JACR), 20(4)

Patient Cost-Sharing and Utilization of Breast Cancer Diagnostic Imaging by Patients Undergoing Subsequent Testing After a Screening Mammogram

Out-of-pocket costs (OOPCs) have been largely eliminated for screening mammography. However, patients still face OOPCs when undergoing subsequent diagnostic tests after the initial screening, which represents a potential barrier to those who require follow-up testing after initial testing. This study examines the association between the degree of patient cost-sharing and the use of diagnostic breast cancer imaging after undergoing a screening mammogram. Full Article

Danny R. Hughes, PhD; William Espinoza, MS; Sarah Fein, MS; Elizabeth Y. Rula, PhD; Geraldine McGinty, MD, MBA. 2023. "Patient Cost-Sharing and Utilization of Breast Cancer Diagnostic Imaging by Patients Undergoing Subsequent Testing After a Screening Mammogram," JAMA Network Open

Urbanicity, Income, and Mammography-Use Disparities Among American Indian Women

Reported breast cancer screening among American Indian women is consistently below that of White women. The last claims-based trends were from 1991 to 2001. This study updates mammography trends for American Indian women and examines the impact of race, urbanicity, and income on long-term mammography use. Full Article

Eric W. Christensen, PhD Casey E. Pelzl, MPH Bhavika K. Patel, MD Ruth C. Carlos, MD, MS Elizabeth Y. Rula, PhD. 2023. "Urbanicity, Income, and Mammography-Use Disparities Among American Indian Women," American Journal of Preventive Medicine, 64(5)

Relationship between Race and Access to Newer Mammographic Technology in Women with Medicare Insurance

This study in Radiology examines the relationship between use of newer mammographic technology and race in women receiving mammography services. This was a multiyear (January 2005 to December 2020) retrospective study of women aged 40–89 years with Medicare fee-for-service insurance who underwent mammography. Full Article

Eric W. Christensen, Mikki Waid, Jinel Scott, Bhavika K. Patel, Jacqueline A. Bello, Elizabeth Y. Rula. 2022. "Relationship between Race and Access to Newer Mammographic Technology in Women with Medicare Insurance," Radiology

Impact of the COVID-19 Pandemic on Breast Imaging: An Analysis of the National Mammography Database

The aim of this study was to quantify the initial decline and subsequent rebound in breast cancer screening metrics throughout the coronavirus disease 2019 (COVID-19) pandemic. Full Article

Lars J. Grimm, MD, MHS, Cindy Lee, MD, Robert D. Rosenberg, MD, Judy Burleson, MHSA, Michael Simanowith, MD, Tom Fruscello, Jr., MBA, Casey E. Pelzl, MPH, Sarah M. Friedewald, MD, Linda Moy, MD, Margarita L. Zuley, MD. 2022. "Impact of the COVID-19 Pandemic on Breast Imaging: An Analysis of the National Mammography Database," Journal of American College of Radiology (JACR)

An Empiric Medicare Claims-Based Utilization Approach to Mitigating the Iodinated Contrast Shortage

The current shortage of iodinated contrast in the United States due to the COVID-19 related production shutdown in China is causing severe disruptions in patient care. A new Harvey L. Neiman Health Policy Institute study outlines the most frequently used computed tomography (CT) services performed on Medicare beneficiaries as focus areas for mitigation strategies for the greatest overall impact. Full Article

Richard Duszak Jr. MD, Jennifer Hemingway, MS, Eric W. Christensen, PhD, Amit M.Saindane, MD, MBA, Danny R.Hughes, PhD, Elizabeth Y. Rula, PhD. 2022. "An Empiric Medicare Claims-Based Utilization Approach to Mitigating the Iodinated Contrast Shortage," Journal of American College of Radiology (JACR), 19(7)

Updated Trends, Disparities, and Clinical Impact of Neuroimaging Utilization in Ischemic Stroke in the Medicare Population: 2012 to 2019

The purpose of this study was to update trends, investigate sociodemographic disparities, and evaluate the impact on mortality of stroke neuroimaging across the United States from 2012 to 2019. Full Article

Jason J. Wang, PhD, Casey E. Pelzl, MPH, Artem Boltyenkov, PhD, Jeffrey M. Katz, MD, Jennifer Hemingway, MS, Eric W. Christensen, PhD, Elizabeth Rula, PhD, Pina C. Sanelli, MD, MPH. 2022. "Updated Trends, Disparities, and Clinical Impact of Neuroimaging Utilization in Ischemic Stroke in the Medicare Population: 2012 to 2019," Journal of American College of Radiology (JACR), 19(7)

April 21, 2022

Research Rounds: Price Transparency: Progress or Problems?

Consumer price listings may ultimately give consumers less of what they really want — high quality care. While transparent pricing is theoretically ideal for allowing patients to make informed decisions, the complexity of healthcare in the U.S. makes a truly transparent system a challenge and there are numerous caveats. Read the JACR Bulletin Column