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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.

Neiman Almanac Methods

Volume of Services Performed

Utilization rate is the frequency of imaging services each year per 1,000 Medicare beneficiaries. Global and professional components are included while technical components are excluded as to not double count. National numbers are limited to the 50 states and DC. Imaging and imaging modalities are identified by Neiman Imaging Types of Services (NITOS) The total number of beneficiaries is the number of beneficiaries, who submitted a claim of any type in that year, in the data set. Total Imaging and All Imaging are all images as defined by NITOS, not the summation or limited to listed modalities.

 

Spending on Radiology Services

Spending rate is the total of allowed charges each year per 1,000 Medicare beneficiaries. National numbers are limited to the 50 states and DC. Imaging and imaging modalities are identified by Neiman Imaging Types of Services (NITOS). The total number of beneficiaries are calculated by the number of beneficiaries, who submitted a claim of any type in that year, in our data set. Total Imaging and All Imaging is any imaging as defined by NITOS, for all imaging modalities, not the summation or limited to the modalities there are series on.

 

Radiology Access and Workforce

Series using the source American Hospital Association (AHA) Annual Survey Database modalities are determined by AHA definitions.

 

Place of Service

In the series with sources CMS Physician/Supplier Procedure Summary Master File and CMS Physician/Supplier Procedure Summary Master File, the place of service is defined by the following Claim Place of Service Codes:

 

Code Code Value
23 Emergency Departments
22 Outpatient Settings
21 Inpatient Settings
11 Office Settings
All Settings Unrestricted, not limited to the above places of service

 

Neiman Imaging Types of Services (NITOS)

Neiman Imaging Types of Services (NITOS) codes provide a variable that can be merged into datasets by HCPCS code to identify imaging procedures by modality and anatomic site. This coding system augments the existing BETOS system for imaging focused studies and was designed to be usable either in conjunction with or in lieu of BETOS for imaging analyses. The methods of NITOS can be found here.

Total Imaging and All Imaging is any imaging as defined by NITOS for all imaging modalities, not the summation or limited to the modalities there are series on.

 

Description of Data Sets

CMS 5% Research Identifiable Files (RIF)

Research Identifiable Files (RIFs) contain many files of beneficiary-level protected health information (PHI). The 5% version, used in these figures, has five percent of all Medicare Part B beneficiaries and 100% of the claims for these beneficiaries. The Carrier File of the RIF is used to calculate volume, spending, and beneficiary denominators. The Carrier File includes fee-for-service claims submitted by professional providers, including physicians, physician assistants, clinical social workers, nurse practitioners.

 

CMS Physician/Supplier Procedure Summary Master File

The Physician/Supplier Procedure Summary (PSPS) LDS file is a summary of calendar year Medicare Part B carrier and durable medical equipment fee-for-service claims. The file is organized by carrier, pricing locality, Healthcare Common Procedure Coding System (HCPCS) code, HCPCS modifier, provider specialty, type of service, and place of service. The summarized fields are total submitted services and charges, total allowed services and charges, total denied services and charges, and total payment amounts. This file is not the redacted publicly available file.

 

AHA Annual Survey Database

The AHA Annual Survey of Hospitals profiles a universe of more than 6,200 hospitals and health care systems throughout the United States and associated areas.

 

Citation

Please cite this data as “The Neiman Almanac. https://www.neimanhpi.org/almanac/ . Accessed: mm/dd/yyyy”