The Radiology Support, Communication and Alignment Network (R-SCAN) is a quality improvement program through which patients, referring clinicians, and radiologists collaborate to improve imaging appropriateness based on Choosing Wisely recommendations and ACR Appropriateness Criteria. R-SCAN was shown previously to increase the odds of obtaining an appropriate, higher patient or diagnostic value, imaging study. In the current study, the researchers aimed to estimate the potential imaging cost savings associated with R-SCAN use for the Medicare population. Full Article
Max Wintermark, MD, MAS, MBA , Andrew B. Rosenkrantz, MD, Paymon G. Rezaii, MS, Nancy Fredericks, MBA, Laura Chaves Cerdas, MS, Judy Burleson, MHSA, G. Rebecca Haines, MSM, CPXP, Mythreyi Chatfield, PhD William T. Thorwarth Jr., MD, Richard Duszak Jr., MD, Danny R. Hughes, PhD. 2021. "Predicted Cost Savings Achieved by the Radiology Support, Communication and Alignment Network from Reducing Medical Imaging Overutilization in the Medicare Population," Journal of American College of Radiology (JACR)
Optimization of neuroimaging practices for headache is considered a national priority; however, nationwide patterns and predictors of neuroimaging use for headache in the US emergency departments (EDs) are unknown. The objective of this study is to analyze temporal neuroimaging utilization trends for adults and children with non-traumatic headache in the US EDs and identify factors predictive of neuroimaging use in this patient population. Full Article
Trofimova Anna, MD, PhD, Richard Duszak Jr, MD, Nadja Kadom, MD, Gelareh Sadigh, MD. 2021. "Increasing and Disparate use of Neuroimaging for Adults and Children with Non‐Traumatic Headaches in the US Emergency Departments: Opportunities for Improvement," Headache
The purpose of this study was to assess potential disparities in the utilization of advanced imaging during emergency department (ED) visits. This retrospective study was conducting using 5% Research Identifiable Files. All CT and MRI (together defined as “advanced imaging”) examinations associated with ED visits in 2015 were identified for continuously enrolled Medicare beneficiaries. Among Medicare beneficiaries receiving care in U.S. EDs, significant disparities exist in advanced imaging utilization. Although imaging appropriateness was not investigated, these findings suggest inequity. Further research is necessary to understand why consistent health benefits do not translate into consistent imaging access among risk-adjusted ED patients. Full Article
Tarek N. Hanna, MD, Eric Friedberg, MD, Ivan M. Dequesada, MD, Laura Chaves, MPP, Robert Pyatt, MD, Richard Duszak, Jr., MD, Danny R. Hughes, PhD. 2021. "Disparities in the Use of Emergency Department Advanced Imaging in Medicare Beneficiaries," American Journal of Roentgenology
The purpose of this study is to assess recent trends and characteristics in radiologist-practice separation across the United States. Using the Medicare Physician Compare and Medicare Physician and Other Supplier Public Use File data sets, the researchers linked all radiologists to associated group practices annually between 2014 and 2018 and assessed radiologist-practice separation over a variety of physician and group characteristics. Multivariate logistic regression modeling was used to estimate the likelihood of radiologist-practice separation. Full Article
Stefan Santavicca, MS , Danny R. Hughes, PhD, Howard B. Fleishon, MD, MMM, Frank Lexa, MD, MBA Eric Rubin, MD, Andrew B. Rosenkrantz, MD, MPA, Richard Duszak, MD. 2020. "Radiologist-Practice Separation: Recent Trends and Characteristics," Journal of American College of Radiology (JACR)
Using the Medicare Physician-Supplier Procedure Summary Master File, we evaluated the evolving use of fMRI in
Medicare fee-for-service beneficiaries from 2007 through 2017. Annual use rates (per 1,000,000 enrollees) increased from 17.7 to
32.8 through 2014 and have remained static since. Radiologists have remained the dominant specialty group from 2007 to 2017
(86.4% and 88.6% of all services, respectively), and the outpatient setting has remained the dominant place of service (65.4% and
65.4%, respectively). Full Article
Solmaz Asnafi, MD, Richard Duszak Jr, MD, Jennifer M. Hemingway, MS, Danny R. Hughes, PhD, Jason W. Allen, MD, PhD. 2020. "Evolving Use of fMRI in Medicare Beneficiaries," American Journal of Neuroradiology
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
The aim of this study was to explore state-level relationships between the incidence and payout amounts for medical malpractice claims and Medicare imaging utilization and spending across the United States. Full Article
Alexander Villalobos, MD, Michal Horný, PhD, Danny R. Hughes, PhD, Richard Duszak, MD. 2020. "Associations Over Time Between Paid Medical Malpractice Claims and Imaging Utilization in the United States," Journal of American College of Radiology (JACR)
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.
The operational and financial impact of the widespread coronavirus disease 2019 (COVID-19) curtailment of imaging services on radiology practices is unknown. We aimed to characterize recent COVID-19-related community practice noninvasive diagnostic imaging professional work declines. The authors used imaging metadata from nine community radiology practices across the United States between January 2019 and May 2020, and mapped work relative value unit (wRVU)-weighted stand-alone noninvasive diagnostic imaging service codes to both modality and body region. Full Article
Richard Duszak Jr, MD, Jeff Maze, MB, Candice Sessa, MS, Howard B. Fleishon, MD, Lauren P. Golding, MD, Gregory N. Nicola, MD, Danny R. Hughes, Ph. 2020. "Characteristics of Coronavirus Disease 2019 (COVID-19) Community Practice Declines in Noninvasive Diagnostic Imaging Professional Work," Journal of American College of Radiology (JACR)
The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on imaging utilization across practice settings. The purpose of this study was to quantify the change in the composition of inpatient imaging volumes for modality types and Current Procedural Terminology–coded groups during the COVID-19 pandemic. Full Article
Jason J.Naidich,MD, Artem Boltyenkov, PhD, Jason J.Wang, PhD, Jesse Chusid, MD, Danny Hughes, PhD, Pina C.Sanelli, MD. 2020. "Coronavirus Disease 2019 (COVID-19) Pandemic Shifts Inpatient Imaging Utilization," Journal of American College of Radiology (JACR), 17(10)
