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The Harvey L. Neiman Health Policy Institute® studies the value and role of radiology in evolving health care delivery and payment systems, including quality based approaches to care and the impact of medical imaging on overall health care costs. Neiman Institute research provides a foundation for evidence-based imaging policy to improve patient care and bolster efficient, effective use of health care resources. Read the 2016 Neiman Institute Annual Report.

Alternative Health Care Models

Digital Breast Tomosynthesis Implementation: Considerations for Emerging Breast Cancer Screening Bundled Payment Models

Bundled payments have been touted as mechanisms to optimize quality and costs. A recent feasibility study evaluating bundled payments for screening mammography episodes predated widespread adoption of digital breast tomosynthesis (DBT). We explore a similar model reflecting emerging acceptance of DBT in breast cancer screening. Methods: Using 4-year data for 59,094 screening episodes from two large facilities within a large academic health system, we utilized published methodology to calibrate Medicare national allowable reference prices for women undergoing screening mammography before and after practice-wide implementation of DBT. Full Article

Margaret M. Fleming, MD, MS, Danny R. Hughes, PhD, Lauren P. Golding, MD, Geraldine B. McGinty, MD, MBA, Dan MacFarlane, BS, CPA, Richard Duszak Jr, MD. 2019. "Digital Breast Tomosynthesis Implementation: Considerations for Emerging Breast Cancer Screening Bundled Payment Models," Journal of American College of Radiology (JACR), 16(7)

Private Practice Radiologist Subspecialty Classification Using Medicare Claims

The purpose of this study was to assess both existing Medicare provider code assignments and a new claims-based system for subspecialty classifying private practice radiologists. Full Article

Rosenkrantz, A.B., Wang, W., Bodapati, S., Hughes, D.R., Duszak, R. 2017. "Private Practice Radiologist Subspecialty Classification Using Medicare Claims," Journal of the American College of Radiology

Academic Radiologist Subspecialty Identification Using a Novel Claims-Based Classification System

This study assesses the feasibility of a novel claims-based classification system for payer identification of academic radiologist subspecialties. Full Article

Rosenkrantz, A.B., Hughes, D.R., Wang, W., Ginocchio, L., Rosman, D.A., and Duszak, R. 2017. "Academic Radiologist Subspecialty Identification Using a Novel Claims-Based Classification System," American Journal of Roentgenology, 208(6): 1249 - 1255.

MACRA, Alternative Payment Models, and the Physician-Focused Payment Model: Implications for Radiology

This paper suggests that patient-focused physician models provide a compelling opportunity for radiologists to demonstrate and be rewarded for their unique contributions toward patient care, and may foster greater radiologist participation in APMs under MACRA. Full Article

Rosenkrantz, A.B., Nicola G.N., Allen, B., Hughes, D.R., and Hirsch, J.A. 2017. "MACRA, Alternative Payment Models, and the Physician-Focused Payment Model: Implications for Radiology," Journal of the American College of Radiology

The Proposed MACRA/MIPS Threshold for Patient-Facing Encounters: What It Means for Radiologists

This report found that CMS’ proposed criteria for special considerations in new payment models would result in many radiologists being evaluated using measures not reflective of their practice. Full Article

Rosenkrantz A.B., Hirsch J.A., Allen B. Jr., Wang W., Hughes D.R., Nicola G. 2017. "The Proposed MACRA/MIPS Threshold for Patient-Facing Encounters: What It Means for Radiologists," Journal of the American College of Radiology, 14(3): 308 - 315.

MACRA, MIPS, and the New Medicare Quality Payment Program: An Update for Radiologists

This report provides an overview of CMS’ proposal for implementing MACRA legislation via the new QPP, paying specific attention to the implications and imperatives for radiologists under MIPS. Full Article

Rosenkrantz, A.B., Nicola G.N., Allen, B., Hughes, D.R., and Hirsch, J.A. 2017. "MACRA, MIPS, and the New Medicare Quality Payment Program: An Update for Radiologists," Journal of the American College of Radiology, 14(3): 316 - 323.

September 19, 2016

Radiology and the Shared Savings ACO

A new Neiman Institute paper, published in collaboration with industrial engineers from Virginia Tech, investigates how the incentives in an alternative payment model, the Accountable Care Organization Share Savings Program, might influence cost, quality, utilization, and technological investment. Read More

Modeling and Designing Health Care Payment Innovations for Medical Imaging

This paper specifically studies the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs) and determines how this incentive program affects computed tomography (CT) use, and how it could be redesigned to minimize unnecessary CT scans. Full Article

Zhang, H., Wernz, C., Hughes, D.R. 2016. "Modeling and Designing Health Care Payment Innovations for Medical Imaging," Health Care Management Science

An Empirical Framework for Breast Screening Bundled Payments

This study reports that breast cancer screening provides a framework for radiologist-led bundled payment models. Full Article

Hughes, D.R., Jiang, M., McGinty, G.B., Shetty, S., Duszak Jr, R. 2017. "An Empirical Framework for Breast Screening Bundled Payments," Journal of the American College of Radiology, 14(1): 17 - 23.

July 19, 2016

Data and Analytics: Leveling the New Payment World Playing Field

“Savvy radiologists who avail themselves of [ICE-T] will be prepared to play strong offense not just with joint replacement bundles, but with any inpatient bundled payment initiative CMS throws at them,” says Neiman Institute Affiliate Senior Research Fellow Richard Duszak, MD, FACR. Read More