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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.

Utilization

Disparities in the Use of Emergency Department Advanced Imaging in Medicare Beneficiaries

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

November 29, 2020

The Neiman Institute COVID-19 Studies

To understand the impact of COVID-19 on radiology in a variety of care-delivery settings, the Harvey L. Neiman Health Policy Institute (HPI®) initiated a series of studies from an integrated healthcare system in New York and community radiology practices, and analyzed data from a national survey of radiology practices. View the infographic to see how COVID-19 affected imaging volumes and radiology practices. View Infographic

November 13, 2020

Trends in Radiology Physician Workforce Mobility

Using two separate publicly available Medicare datasets, the researchers studied the frequency and characteristics of radiologist-practice separation between 2014 – 2018. View Infographic

Evolving Use of fMRI in Medicare Beneficiaries

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

Associations Over Time Between Paid Medical Malpractice Claims and Imaging Utilization in the United States

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)

August 19, 2020

Associations Over Time Between Paid Medical Malpractice Claims and Imaging Utilization in the United States

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. View Infographic

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.

Characteristics of Coronavirus Disease 2019 (COVID-19) Community Practice Declines in Noninvasive Diagnostic Imaging Professional Work

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)

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)

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