August 10, 2017
The Harvey L. Neiman Health Policy Institute™ annual report for Fiscal Year (FY) 2016. The report highlights several key accomplishments, including the launch of the Inpatient Cost-Evaluation Tool (ICE-T), a Journal of the American College of Radiology (JACR) report on a proposed breast cancer screening bundle and numerous other scientific achievements.
The Harvey L. Neiman Health Policy Institute studies the value and
role of radiology and radiologists in evolving health care delivery
and payment systems.
Senior Director’s Message
By Danny R. Hughes, PhD
I am pleased to state that this annual report reflects the
tremendous accomplishments of the Harvey L. Neiman Health
Policy Institute over the past calendar year.
At present, lawmakers and regulators are making policy decisions
about medical imaging without knowing the full effects on
individual patients or the health care system as a whole.
Radiologists are being asked to participate in alternative payment
models without data to ascertain their appropriate share of
payments and without knowledge of how to best participate in
these nontraditional environments. The Neiman Institute provides
this much needed information and helps ensure that future
imaging policies benefit patients and make efficient and effective
use of health care resources.
• Over the past year, the Neiman Institute successfully launched
the Inpatient Cost-Evaluation Tool (ICE-T), which allows
radiology practices and hospitals to compare their internal
costs to national benchmarks to decide if bundled payment for
specific services should be pursued. This web-based resource
assists radiology practices in deciding which inpatient diagnosis
related groups (DRG) to bundle and how they may participate
in DRG-based bundled payments. Using this and other Neiman
Institute online data tools, radiologists can prepare and
succeed in CMS’ evolving payment models.
• A 2016 Neiman Institute paper, published online in the Journal
of the American College of Radiology (JACR), proposed a
breast cancer screening bundle that provides a framework
for radiologist-led bundled payment models, and can be
implemented with different services included in the bundle
• We continued to expand our research portfolio by publishing
18 new studies in peer-reviewed journals and presenting research
at several academic and professional meetings, which garnered
media coverage for the Institute in several news outlets, including
Radiology Business, DOT Med News, HealthImaging
• We significantly expanded our social media presence on
Facebook, Twitter and LinkedIn.
With more research on the horizon, there will be much to discuss in
the coming months and I hope you will continue to follow the exciting
work of our research staff, fellows and grantees. More information
about the Institute’s work can be found at neimanhpi.org. I offer
a special thanks to the Neiman Institute Advisory Board for their
support. It is truly an honor and privilege to serve this dynamic
organization, and we look forward to continuing to provide rigorous,
policy-relevant research and tools for the benefit of the radiology community.
Danny R. Huhges, PhD
In 2016, the Neiman Institute had 18 papers published or accepted
for publication. This brought the Institute to a total of 48 published
papers since 2013. The calculated impact factor of Neiman Institute
research was 4.20 in 2015 and 3.74 in 2016.
Neiman Institute research and data tools were presented 15 times
at several national conferences in the health policy, radiology and non-radiology space including:
American College of Radiology
American Roentgen Ray Society
Association of University Radiologists
Radiological Society of North America
American Public Health Association
American Society of Health Economists
The Institute for Operations Research and the Management Sciences
In addition, the Institute connected directly with radiology
practices at several meetings and events. In total, the Institute
presented 20 times, including the ACR 2016 annual meeting,
the Radiology Business Management Association meetings, the
Economics of Diagnostic Imaging Symposium, and several ACR
Awards and Recognition
The Neiman Institute was the recipient of numerous awards for its
research and data tools.
• A Neiman Institute study earned the Charles
E. Gibbs Leadership Prize for the best paper
published in Women’s Health Issues in 2015.
“Screening Mammography Rates in the
Medicare Population before and after the 2009
U.S. Preventive Services Task Force Guideline
Change: An Interrupted Time Series Analysis,”
authored by Miao Jiang, PhD, and coauthored
by Danny R. Hughes, PhD, and Richard Duszak,
MD, FACR, was the first Neiman Institute paper
to win this prestigious award.
S. Patel, J. Hemingway, J. Rawson, D.R. Hughes, R. Duszak
“Changing Utilization of Brain Imaging in the Emergency
Department: Perspectives from Nearly Two Decades of
National Medicare Claims.”
G. Gan, P. Harkey, J. Hemingway, D.R. Hughes, R. Duszak
“Changing Utilization Patterns of Cervical Spine Imaging
in the Emergency Department Setting: Perspectives from
Two Decades of National Medicare Claims.”
Neiman Institute Tool Named Finalist for
Radiology Excellence Award
The Neiman Institute’s ICE-T (Inpatient Cost
Evaluation Tool) was a finalist in the 2016 edition
of the Minnies, auntminnie.com’s annual campaign
to recognize the best and brightest in medical
imaging. ICE-T, was included in the Best New
Radiology Software category.
In addition, Neiman Institute Senior Director for
Health Policy Research and Senior Research Fellow
Danny Hughes, PhD, was named a semi-finalist in the
Most Influential Radiology Researcher category and
a Neiman Institute study, “Recent Medicare Policy
Initiatives and the Relative Utilization of “Double
Scan” Computed Tomography,” published in the
Journal of the American College of Radiology (JACR),
was named a semi-finalist in the Scientific Paper of
the Year category.
In 2016, the Neiman Institute produced policy-influencing
• Publishing evidence supporting the successful rollback of
the multiple procedure payment reduction (MPPR), one of
radiology’s most maligned reimbursement cuts.
• Providing analysis that influenced the Centers for Medicare
and Medicaid Services’ (CMS) definition of a non-patient facing
clinician under the Merit-Based Incentive System (MIPS).
In addition, the Institute informed practices coping with evolving
payment reform by:
• Issuing multiple JACR papers about the Medicare Access
and CHIP Reauthorization Act of 2015 (MACRA) and MIPS
requirements, and specifically what practices can do to best
Finally, the Institute examined the role of radiology practices in
alternative payment models (APMs) by:
• Developing a bundled payment model for breast cancer
screening. The study, published in the JACR, reported that
breast cancer screening provides a framework for radiologistled
bundled payment models, and can be implemented with
different services included in the bundle depending upon
a practice’s specific patient panel.
• Presenting the model to CMS as a radiology-driven APM and
as a potential episode for meeting MIPS requirements.
Neiman Institute Website: neimanhpi.org
Since the Neiman Institute website launched in November 2014,
it has resulted in more than:
• 78,000 page views
• 28,000 sessions
• 17,500 users
The Neiman Institute website delivers accurate data to help
lawmakers, regulators and payers make informed policy decisions
that will improve patient care. The website attracts visitors from over
2,300 internal service providers for government health agencies,
leading academic institutions, private payers and numerous private
firms and consultancies such as:
• The Centers for Medicare & Medicaid Services
• The U.S. Department of Health and Human Services
• The Medicare Payment Advisory Commission
• The National Institutes of Health
• The United States Department of Veterans Affairs
• The National Health Service (United Kingdom)
• Harvard University
• The Johns Hopkins University
• The Massachusetts Institute of Technology
• Yale University
• UnitedHealth Group Inc.
• The Advisory Board Company
Web-Based Data Tools
Neiman Institute Tool Assists in Radiology Bundle Building
In 2016, the Institute released the Inpatient Cost Evaluation Tool (ICE-T) (neimanhpi.org/ice-t/), which enables radiology practices and hospitals to compare internal costs to national benchmarks to decide
if bundled payment for specific services should be pursued. ICE-T
aggregates multiple years of Medicare inpatient claims data and
allows the user to examine both hospital and imaging costs across
The Neiman Almanac: A Powerful Tool for Radiology Researchers
The Neiman Almanac (neimanhpi.org/almanac) allows users to
create easy-to-read graphs and maps from more than 125 data
sets related to radiology access, workforce issues, spending and
volume. The Almanac offers reporters, researchers and others free
online access to the most up-to-date medical imaging utilization,
cost, access and workforce data available. This speeds collection
of radiology services data for a number of uses — including news
reports, health policy papers and government planning.
Enhanced Media and Public Visibility
Neiman Institute research garnered media coverage in several news
outlets, including Radiology Business, DOT Med News, HealthImaging
and AuntMinnie.com, resulting in 43 articles in online media outlets
reaching 455,000 confirmed readers.
With the increased use of social media, production of information
graphics featured prominently in the Neiman Institute’s
communications strategy in 2016. The Institute released several
shareable graphics based on data from the Neiman Almanac, which
aggregates multiple years of data from varying data sources to
create dynamic tables of both state and national figures on volume, spending, access and workforce of radiology services.