A study by the Harvey L. Neiman Health Policy Institute conducted a detailed review of clinical services billed to Medicare by non-physician providers (NPPs) employed by radiology practices. The study, published in the Journal of the American College of Radiology, was based on Centers for Medicare and Medicaid Services databases of doctors and clinicians who participated in Medicare.
Two research teams have each been awarded $75,000 in grant funds from the Harvey L. Neiman Health Policy Institute. The new Neiman Institute grant program provides funding for research aimed to inform health policy toward improving patient care and ensuring the proper use of healthcare resources.
The current shortage of iodinated contrast in the United States due to the COVID-19 related production shutdown in China is causing severe disruptions in patient care. A new Harvey L. Neiman Health Policy Institute study outlines the most frequently used computed tomography services performed on Medicare beneficiaries as focus areas for mitigation strategies for the greatest overall impact.
A new Harvey L. Neiman Health Policy Institute study found that a significant upward trend in CTA, CTP, and MRI utilization, and a simultaneous downtrend in MRA use was observed for ischemic stroke cases while disparities existed in neuroimaging utilization across all demographic groups.
A new Harvey L. Neiman Health Policy Institute study found that between 2017 and 2019 the number of non-physician providers (NPPs, which includes nurse practitioners and physician assistants) employed by radiology-only practices increased 18%. This increase was associated with more NPPs employed per practice as well as an 11% increase in the number of practices employing them. This Journal of the American College of Radiology study was based on Centers for Medicare and Medicaid Services databases of doctors and clinicians who participated in Medicare.
A new Harvey L. Neiman Health Policy Institute study found that as of September/October 2021, only 50% of hospitals that offered lumbar spine MRI were compliant with the Center for Medicare and Medicaid Services (CMS) mandate to publish their prices online.
A new Harvey L. Neiman Health Policy Institute study of nearly 800,000 men found that between 2011 and 2017 black patients were 24% less likely than white patients to have a prostate MRI after receiving an elevated (prostate-specific antigen) PSA score. For patients with an elevated PSA, use of prostate MRI prior to prostate biopsy has increased substantially in recent years as MRI can improve identification of clinically significant prostate cancer and obviate the need for biopsy, thus decreasing overdiagnosis of these cases. This JAMA Network Open study was based on 794,809 men, age 40 or older, with a PSA test using claims data from the Optum Clinformatics Data Mart Database. Of these men, 51,500 had an PSA score >4ng/mL. The study found that patients with Medicare compared to commercial insurance were less likely to have a prostate MRI as were patients with HMO insurance plans compared to other plan types.
The Neiman Health Policy Institute is accepting applications for its new grants and fellowship programs to fund novel research to inform health policy and radiology practice. Grant topics include payment models, AI/emerging technology, and practice advancements to improve efficiency, outcomes, or equity. For full details, please see the Grants & Fellowship page.
A new Harvey L. Neiman Health Policy Institute study found that patients paid 12% of the costs of secondary imaging interpretation out-of-pocket. Such secondary interpretations are increasingly performed for complex patients, but patients’ liabilities and paid out-of-pocket costs were not previously known. This Journal of the American College of Radiology (JACR) study was based on 7,740 secondary interpretations for adult patients performed in a large metropolitan health system over a 2-year period.
A new Harvey L. Neiman Health Policy Institute study, published in Radiology, reviewed the implications of unexpected out-of-network balance billing—commonly called surprise billing—on reimbursement for hospital-based specialties such as radiology. The analysis concluded that even physicians who never engaged in such billing practices may still be impacted by the No Surprises Act, which is due to take effect in 2022.
According to a new study, by the Harvey L. Neiman Health Policy Institute and the American College of Radiology’s National Mammography Database Committee, the most influential radiologist characteristics impacting mammography interpretive performance were geography, breast sub-specialization, performance of diagnostic mammography, and performance of diagnostic ultrasound.
This new Harvey L. Neiman Health Policy Institute study found that radiologist participation in Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) increased over three-fold from 10.4% to 34.9% between 2013 and 2018. The study is published online in the Journal of American College of Radiology.
A new Harvey L. Neiman Health Policy Institute study found a 50% increase in screening computed tomography colonography (CTC) rates after the U.S. Preventive Services Task Force (USPSTF) announcement of the updated recommendation on colorectal cancer screening in 2016. This American Journal of Preventive Medicine study evaluated the association among the updated recommendation, patient cost sharing, and the uptake of colorectal cancer screening through CTC in the privately insured population.
This new American Journal of Neurology (AJNR) study found that radiologists performed 54% of lumbar puncture procedures (LPs) in 2017, representing significant growth over the 14 year longitudinal study. This study evaluated trends in performance of LPs by various medical specialties from 2003 to 2017 and raises the question of whether the shift of LPs from other specialties to radiology is justified. The results were also featured at the annual meeting of the Radiological Society of North America, 2021.
A new Harvey L. Neiman Health Policy Institute study showed that nearly 20% of radiologists separated from a practice in a single year, indicating that radiology is impacted by broader workforce trends toward job hopping. This Journal of American College of Radiology (JACR) study tracked recent trends and characteristics of radiologist-practice separation across the United States.
A new Harvey L. Neiman Health Policy Institute study found that functional magnetic resonance imaging (fMRI) steadily increased from 2007-2014 but has now been static due to potential expansion barriers. This diagnostic imaging method is critical in determining brain functions as well as for assessing the potential risks of surgery or other invasive treatments of the brain. This American Journal of Neuroradiology (AJNR) study is the first of its kind to assess the nationwide adoption of fMRI.
Researchers supported by the Neiman Health Policy Institute (NPHI) find that higher numbers of paid malpractice claims are associated with a subsequent increase in advanced imaging utilization. The Journal of American College of Radiology study examined the quantity and cost of malpractice claims and Medicare imaging utilization at the state and national level.
A new study from Harvey L. Neiman Health Policy Institute finds that over ¾ of Multiple Sclerosis (MS) patients face financial toxicity that often results in non-adherence to follow up care. This Multiple Sclerosis Journal study is the first of its kind to evaluate financial toxicity in MS patients and whether financial hardship is linked to patients foregoing the therapy and imaging follow-up prescribed in their treatment plan.
Imaging today plays essential roles in the management of almost all non-cutaneous cancers, influencing diagnosis, assessment of prognosis, treatment selection, and therapeutic monitoring. Achieving consistently high-quality oncologic imaging (OI) interpretations poses an increasing challenge in light of the growing complexity of such imaging and of oncologic care. This new Harvey L. Neiman Health Policy Institute study, published on in the Journal of the American College of Radiology (JACR), characterizes national trends in oncologic imaging utilization.
As medical resources shifted away from elective and non-urgent procedures toward emergent and critical care of COVID-19 patients, departments were forced to reconfigure their personnel and resources. In particular, many Radiology practices rescheduled non-urgent and routine imaging according to recommendations from the American College of Radiology (ACR). This new Harvey L. Neiman Health Policy Institute study, published online in the Journal of American College of Radiology (JACR), evaluates the change in the inpatient imaging volumes and composition mix during the COVID-19 pandemic within a large healthcare system.
The COVID-19 pandemic has quickly spread across all 50 United States. Associated recommendations that healthcare facilities defer non-urgent visits, tests, and procedures led many imaging facilities to temporarily curtail most of their non-urgent services. This new Neiman Institute study characterizes the recent declines in non-invasive imaging volumes at community practices.
As a result of the COVID-19 pandemic many radiology departments have experienced a rapid decline in imaging case volumes. This new study, funded by the Harvey L. Neiman Health Policy Institute and published online in Journal of the American College of Radiology (JACR), evaluates the impact of the pandemic on imaging case volumes using real-world data from a large healthcare institution.
General radiologists serve an essential role in the national radiologist workforce by offering broad radiological skills that help their practices meet a variety of geographic and after-hour coverage needs. Importantly, generalists have a particular role in ensuring patient access to radiological services for small and rural radiology groups. While subspecialty radiologists practice patterns have been well studied, relatively little is known about practice patterns of general radiologists. This new study, published in Academic Radiology, characterizes the practice patterns of general radiologists, who represent the majority of practicing radiologists in the US.
Concerns regarding increasing utilization of non-vascular extremity ultrasound (US) imaging led to the Current Procedural Terminology (CPT) Editorial Panel to separate a singular billing code into distinct comprehensive and focused examination codes with differential reimbursement. This new Harvey L. Neiman Health Policy Institute study, published online in Current Problems in Diagnostic Radiology, explores the association of the billing code separation on nonvascular extremity US utilization, with attention to specialty-specific variation.
CMS has implemented a quality payment incentive program, referred to as the Quality Payment Program, which rewards value and outcomes for clinicians participating in Medicare in one of two ways: Merit-based incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).
A new Harvey L. Neiman Health Policy Institute study assesses temporal and patient-level differences in paracentesis and thoracentesis procedures performed on Medicare beneficiaries by radiologists and non-radiologists with respect to overall procedure volume, day of week, and patient complexity. The study is published online in Journal of Vascular and Interventional Radiology.
A new study performed in conjunction with the Harvey L. Neiman Health Policy Institute examines changing characteristics of utilization and potential disparities in US emergency department (ED) patients undergoing CT of the abdomen and pelvis (CTAP) for suspected urolithiasis.
A new research study by Harvey L. Neiman Health Policy Institute found that utilization of invasive procedures on hemodialysis conduits—artificially constructed shuts used by many individuals who require dialysis—increased markedly from 2001 through 2015 for nephrologists and declined for radiologists. The study is published online in the Journal of Vascular and Interventional Radiology (JVIR).
Computed tomography (CT) of the head uses special x-ray equipment to help assess head injuries, dizziness, and other symptoms of the brain. This new study, published online in Current Problems in Diagnostic Radiology, evaluates the complexity of patients undergoing head-CT examinations.
After a period of prior growth, national inferior vena cava (IVC) filter utilization in the Medicare population has markedly declined over the last decade according to a prior Harvey L. Neiman Health Policy Institute study published in 2018. How IVC filter utilization has varied at the state level as well as across different payer populations during the recent decline in utilization is unknown. This new study, published online in the American Journal of Roentgenology, assesses state level IVC filter utilization and expands the population set to include both the Medicare and the privately insured population.
As interventional radiology (IR) evolves as a distinct specialty from diagnostic radiology (DR), the central and ongoing role of diagnostic radiologists in performing certain invasive radiological procedures could have important patient access implications.
A new Harvey L. Neiman Health Policy Institute study assesses national and state-specific changes in emergency department (ED) chest imaging utilization from 1994 to 2015. The new research is published online in the Journal of American College of Radiology (JACR).
Bundled payments have been touted as mechanisms to optimize quality and costs. A prior feasibility study evaluating bundled payments for screening mammography episodes predated widespread adoption of digital breast tomosynthesis (DBT).
A new Harvey L. Neiman Health Policy Institute study assesses the effect of receiving an Annual Wellness Visit (AWV) between 2011 and 2013 on the annual rate of eight preventive services recommended for the Medicare population following the AWV. The study is published online in Preventive Medicine.
The American College of Radiology’s Neiman Institute and the Georgia Institute of Technology announced a new five-year, $3 million research partnership to establish the Health Economics and Analytics Lab (HEAL) within Georgia Tech’s Ivan Allen College of Liberal Arts.
Increased awareness of breast tissue density masking cancer and thus decreasing the diagnostic sensitivity of mammography has brought about relevant state-level policies. This new study by Harvey L. Neiman Health Policy Institute examines which characteristics of breast density state-level policies were associated with increased use of downstream breast ultrasound for enhancing earlier detection of breast cancer. The study is published in Medical Care.