Skip to published papers archive

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.

National Trends in Oncologic Diagnostic Imaging

This study characterize national trends in oncologic imaging (OI) utilization. This retrospective cross-sectional study used 2004 and 2016 CMS 5% Carrier Claims Research Identifiable Files. Radiologist-performed, primary noninvasive diagnostic imaging examinations were identified from billed Current Procedural Terminology codes; CT, MRI, and PET/CT examinations were categorized as “advanced” imaging. OI examinations were identified from imaging claims’ primary International Classification of Diseases-9 and International Classification of Diseases-10 codes. Imaging services were stratified by academic practice status and place of service. State-level correlations of oncologic advanced imaging utilization (examinations per 1,000 beneficiaries) with cancer prevalence and radiologist supply were assessed by Spearman correlation coefficient.OI usage varied between practice settings. Although the percentage of advanced OI done in academic settings nearly doubled from 2004 to 2016, the majority remained in nonacademic practices. Full Article

Andrew B. Rosenkrantz, MD, Laura Chaves Cerdas, MS, Danny R. Hughes, PhD, Michael P. Recht, MD, Sharyl J. Nass, PhD, Hedvig Hricak, MD, PhD. 2020. "National Trends in Oncologic Diagnostic Imaging," Journal of American College of Radiology (JACR): 1116 - 1122.

Patient-reported financial toxicity in multiple sclerosis: Predictors and association with care non-adherence

Multiple sclerosis (MS) results in considerable financial burdens due to expensive treatment and high rates of disability, which could both impact care non-adherence. Full Article

Gelareh Sadigh, Ruth Carlos, Carolyn Meltzer, Jeffrey M. Switchenko, Neil Lava, Rich Duszak, Danny Hughes, Elizabeth Anne Krupinski. 2020. "Patient-reported financial toxicity in multiple sclerosis: Predictors and association with care non-adherence," Multiple Sclerosis

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)

Invasive Procedural Versus Diagnostic Imaging and Clinical Services Rendered by Radiology Trainees Over Two Decades

The purpose of this study is to characterize evolving radiology trainee exposure to invasive procedures. Full Article

Andrew B. Rosenkrantz, MD, MPA, C. Matthew Hawkins, MD, Lori A. Deitte, MD, Jennifer Hemingway, MS, Danny R. Hughes, PhD, Richard Duszak Jr, MD. 2019. "Invasive Procedural Versus Diagnostic Imaging and Clinical Services Rendered by Radiology Trainees Over Two Decades," Journal of American College of Radiology (JACR), 16(6)

Survey Measures Burnout Among Neurointerventionalists

The toll of burnout on healthcare is significant and associated with physician depression and medical errors. The objective of this study it to assess the prevalence and risk factors for burnout among neurointerventionalists. Full Article

Kyle M Fargen, Adam S Arthur, Thabele Leslie-Mazwi, Rebecca M Garner, Carol A Aschenbrenner, Stacey Q Wolfe, Sameer A Ansari, Guilherme Dabus, Alejandro Spiotta, Maxim Mokin, Italo Linfante, J Mocco, Joshua A Hirsch. 2019. "Survey Measures Burnout Among Neurointerventionalists," Journal of NeuroInterventional Surgery

Volume and Coverage of Secondary Imaging Interpretation Under Medicare, 2003 to 2016

The aim of this study was to assess changing Medicare volumes of, and coverage for, secondary interpretations of diagnostic imaging examinations stratified by modality and body region service families. Full Article

Andrew B. Rosenkrantz, MD, MPA, McKinley Glover, MD, MHS, Stella K. Kang, MD, Jennifer Hemingway, MS, Danny R. Hughes, PhD, Richard Duszak Jr, MD. 2018. "Volume and Coverage of Secondary Imaging Interpretation Under Medicare, 2003 to 2016," Journal of the American College of Radiology

Can You Do Health Disparities Research with Publicly Available Datasets?

This paper reviews existing publicly available data sets that may be useful for performing imaging disparities research. Full Article

Hughes, D.R. 2018. "Can You Do Health Disparities Research with Publicly Available Datasets?," Academic Radiology

Radiologist Professional Payments After Mitigation of CMS’s Multiple-Procedure Payment Reduction Initiatives

The aim of this study was to assess the potential impact of ACR evidence-based advocacy on radiologist professional reimbursement from individual-provider CMS multiple-procedure payment reduction (MPPR) initiatives. Full Article

Sadigh, G., Hughes, D.R., Wang, W., Allen, B., McGinty, G., Silva, E., Duszak, R. 2017. "Radiologist Professional Payments After Mitigation of CMS’s Multiple-Procedure Payment Reduction Initiatives," Journal of the American College of Radiology

Generalist versus Subspecialist Characteristics of the U.S. Radiologist Workforce

To assess subspecialty practice characteristics of the U.S. radiologist workforce. Despite an increased focus on radiology subspecialization, most U.S. radiologists are majority general radiologists on the basis of their work RVUs. Subspecialization is by far more prevalent in larger and academic practices. Full Article

Rosenkrantz, A.B., Wang, W., Hughes, D.R., Duszak, R. 2017. "Generalist versus Subspecialist Characteristics of the U.S. Radiologist Workforce," Radiology

Physician Specialty and Radiologist Characteristics Associated with Higher Medicare Patient Complexity

Meaningfully measuring physician outcomes and resource utilization requires appropriate patient risk adjustment. We aimed to assess Medicare patient complexity by physician specialty and to further identify radiologist characteristics associated with higher patient complexity. Full Article

Rosenkrantz, A.B., Wang, W., Vijayasarathi, A., Duszak, R. 2017. "Physician Specialty and Radiologist Characteristics Associated with Higher Medicare Patient Complexity," Academic Radiology