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.

Breast Screening Bundle Tool

The Breast Screening Bundle Tool is designed to help radiology practices develop bundled payment models for breast cancer screening. The calculated weighted bundled prices are a single price for patients that would cover initial mammography screening and all subsequent imaging screening and diagnostic testing for either: 1) 364 days after the initial screen or 2) a referral for biopsy or positive cancer diagnosis.

If a practice desires to cover only specific services in a bundle, for example, only screening and diagnostic mammography, then the other services in the tool should be assigned values of zero to calculate the bundled price.

Tutorial

Method

Notes:

  1. Only the percentages are used to calculate the bundled prices. However, volume data is provided so that users can input either their practice's percentage or volume data to calculate new bundled rates. The service volume and percentage defaults were estimated with 2013-2015 Medicare 5% Research Identifiable Files (RIF) data using the method detailed in Hughes et al. An Empirical Framework for Breast Screening Bundled Payments. JACR, 2017. 14(1): 17-23.
  2. The professional component and technical component reimbursements default to the 2017 National Medicare Physician Fee Schedule (MPFS) rates.