January 3, 2018
A new Harvey L. Neiman Health Policy Institute study explores the association between county-level measures of radiologist supply and subspecialization and county structural and health-related characteristics. The study is published online in the Journal of American College of Radiology.
In carrying out their work, the researchers leveraged Medicare Physician and Other Supplier Public Use Files were used to subspecialty characterize 32,844 radiologists participating in Medicare between 2012 and 2014. Measures of radiologist supply and subspecialization were computed for 3,143 US counties. The Neiman Imaging Types of Service (NITOS) coding platform was used to map non-invasive diagnostic imaging services’ to specific modalities and body regions. Additional county characteristics were identified using the 2014 County Health Rankings database.
“The strongest county-level associations with a larger radiologist supply were a larger population and a higher urban percentage,” noted Andrew Rosenkrantz, MD, MPA, lead study author and a Neiman Institute affiliate research fellow. “Counties with at least one Medicare-participating radiologist had both higher mammography screening rates as well as slightly lower premature deaths.”
Among 3,143 US counties, 41.5% had at least one CMS-identifiable Medicare-participating radiologist of either generalist or subspecialist. The average number of Medicare-participating radiologists per county was 10.5 and a total of 21.8% of counties had at least one Medicare-participating subspecialist radiologist. The counties with at least one Medicare-participating radiologist, the average of counties’ percent of radiologists being subspecialized was 19.2%, and the average of counties’ average percent of work relative value unit in a single subspecialty at the radiologist level was 42.8%.
“Geographic disparities in radiologist supply at the community level are compounded by superimposed variation in the degree of subspecialization of those radiologists,” said senior author Richard Duszak, MD, FACR, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University and senior affiliate research fellow at the Neiman Institute. “When establishing quality metrics for value-based payment programs, performance expectations and benchmarks should consider the highly variable degree of radiologist subspecialization within individual communities.”
To obtain a copy of the JACR study or to arrange an interview with a Neiman Institute spokesperson, contact Nichole Gay at (703) 648-1665 or firstname.lastname@example.org.
About the Harvey L. Neiman Health Policy Institute
The Harvey L. Neiman Health Policy Institute is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care. Visit us at www.neimanhpi.org and follow us on Twitter, LinkedIn and Facebook.