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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.

Health Policy

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

January 5, 2017

Radiologists and CMS’ Patient Facing Designation

To help radiologists understand whether they – or their practice – are likely to be designated as patient facing for participation in MIPS, the Neiman Institute has provided the Radiologist Patient Facing Dataset. Read More

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.

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.

Alternative Payment Models in Radiology: The Legislative and Regulatory Roadmap for Reform

This paper describes the recent MACRA legislation, including its impacts on payment, the timeline involved and how organizations, including the ACR, are helping to share its rules and regulations. Full Article

Silva, E., McGinty, G.B., Hughes, D.R., and Duszak Jr, R. 2016. "Alternative Payment Models in Radiology: The Legislative and Regulatory Roadmap for Reform," Journal of the American College of Radiology, 13(10): 1176 - 1181.

Traditional Payment Models in Radiology: Historical Context for Ongoing Reform

This paper provides a detailed historical context for payment reform, focusing on the payment quality initiatives and alternative payment model demonstrations that helped provide the foundation of future MACRA-driven payment reform. Full Article

Silva, E., McGinty, G.B., Hughes, D.R., and Duszak Jr, R. 2016. "Traditional Payment Models in Radiology: Historical Context for Ongoing Reform," Journal of the American College of Radiology, 13(10): 1171 - 1175.

Diagnostic Imaging Services in Magnet and Non-Magnet Hospitals: Trends in Utilization and Costs

The purpose of this study was to better understand trends in utilization and costs of diagnostic imaging services at Magnet hospitals and non-Magnet hospitals. Full Article

Jayawardhana, J., and Welton, J.M. 2015. "Diagnostic Imaging Services in Magnet and Non-Magnet Hospitals: Trends in Utilization and Costs," Journal of the American College of Radiology, 12(12): 1357 - 1363.

Identifying Patients With Undiagnosed Chronic Conditions: An Examination of Patient Costs Before Chronic Disease Diagnosis

This study assesses if identifying chronic conditions at earlier stages could produce dramatic savings to the health care system. This study sought to determine whether patients with chronic conditions experienced higher medical costs and imaging costs than patients with nonchronic conditions before the onset of chronic disease. Full Article

Deyo, D., Hemingway, J., and Hughes, D.R. 2015. "Identifying Patients With Undiagnosed Chronic Conditions: An Examination of Patient Costs Before Chronic Disease Diagnosis," Journal of the American College of Radiology, 12(12): 1388 - 1394.