Publications

Differential Access to Breast Magnetic Resonance Imaging Compared with Mammography and Ultrasound

For high-risk women, breast magnetic resonance (MR) is the preferred supplemental imaging option, but spatial access differences may exacerbate disparities in breast care. The primary aim of this study was to examine the relative distance to breast imaging facilities with MR compared to facilities offering mammography or ultrasound. Access to advanced imaging modalities is critical for breast cancer outcomes, so better understanding how more local facilities could be harnessed to provide these services is necessary. This study examined for each modality the association of socioeconomic status (as measured by the ADI) and urbanicity with distance to breast imaging facilities to quantify their relationship with distance-related screening access to breast imaging. Full Article

Eric W. Christensen, PhD, Robert B. Rosenblatt, BS, Anika G Patel, Elizabeth Y. Rula, PhD, Ruth C. Carlos, MD, MS, Anand K. Narayan, MD, PhD, Bhavika K. Patel, MD. 2024. "Differential Access to Breast Magnetic Resonance Imaging Compared with Mammography and Ultrasound," American Journal of Preventive Medicine

Ten-year trends, disparities, and clinical impact of stroke thrombectomy and thrombolysis: a single center experience 2012-2021

As indications for acute ischemic stroke treatment expand, it is unclear whether disparities in treatment utilization and outcome still exist. The main objective of this study was to investigate disparities in acute ischemic stroke treatment and determine impact on outcome. Full Article

Jeffrey M. Katz, MD , Jason J. Wang, PhD, Maria X. Sanmartin, PhD, Jason J. Naidich, MD, MBA, Elizabeth Rula, PhD, Pina C. Sanelli, MD, MPH. 2024. "Ten-year trends, disparities, and clinical impact of stroke thrombectomy and thrombolysis: a single center experience 2012-2021," Journal of Stroke and Cerebrovascular Diseases

Caught Between a Radiation Oncology Case Rate (ROCR) and a Hard Place: Improving Proposed Radiation Oncology Alternative Payment Models

The Radiation Oncology Case Rate (ROCR) aims to shift radiation reimbursement from fee-for-service (FFS) to bundled payments, which would decouple fractionation from reimbursement in the United States. This study compares historical reimbursement rates from 3 large centers and a national Medicare sample with proposed base rates from ROCR. It also tests the impact of methodological inclusion of treatment and disease characteristics to determine if any variables are associated with greater rate differences that may lead to inequitable reimbursement. Full Article

Aaron Bush, MD, Chi-Mei Liu, PhD, Elizabeth Y. Rula, PhD, Join Luh, MD, Nathan Y. Yu, MD, Nadia Laack, MD, Albert Attia, MD, and Mark Waddle, MD. 2024. "Caught Between a Radiation Oncology Case Rate (ROCR) and a Hard Place: Improving Proposed Radiation Oncology Alternative Payment Models," International Journal of Radiation Oncology, Biology, Physics

Share of Diagnostic Imaging Interpretation: Radiology and Other Specialties

The aim of this study was to examine radiology’s and other specialties’ market shares for diagnostic imaging interpretation for Medicare fee-for-service claims by modality, body region, and place of service. Full Article

Eric W. Christensen, PhD, Elizabeth Y. Rula, PhD, Jeffrey H. Newhouse, MD. 2024. "Share of Diagnostic Imaging Interpretation: Radiology and Other Specialties," Journal of the American College of Radiology (JACR)

Changes in the Radiology Practice Landscape and Indicators of Practice Consolidation From 2014 to 2023

A range of economic and health policy incentives are leading to ongoing consolidation among payers, hospitals, and physician practices. The objective of this study is to evaluate consolidation among radiologists' affiliated practices through 2023, analyze the impact of consolidation on such practices' specialty mix and size, and assess radiologists' new affiliations after prior practices cease. Full Article

Eric W. Christensen, PhD, YoonKyung Chung, PhD, Elizabeth Y. Rula, PhD, Jay R. Parikh, MD. 2024. "Changes in the Radiology Practice Landscape and Indicators of Practice Consolidation From 2014 to 2023," American Journal of Roentgenology

Medicare Volume Growth and Shift in Payments From Physicians to Non-Physician Practitioners Under Statutory Budget Neutrality

Volume increases, inflation, statutory freezes in physician payments, and the budget neutrality requirement for the Medicare Physician Fee Schedule have resulted in persistent inflation-adjusted conversion factor decreases. This study aimed to determine if relative value unit (RVU) volume increases on a per beneficiary basis has counteracted conversion factor decreases and inflation to maintain Medicare reimbursement per beneficiary, overall and across specialties. Full Article

Eric W. Christensen, PhD, Gregory N. Nicola, MD, Elizabeth Y. Rula, PhD, Lauren P. Nicola, MD, Joshua A. Hirsch, MD. 2024. "Medicare Volume Growth and Shift in Payments From Physicians to Non-Physician Practitioners Under Statutory Budget Neutrality," INQUIRY: The Journal of Health Care Organization, Provision, and Financing

Bone Density Screening Rates Among Medicare Beneficiaries: An Analysis with a focus on Asian Americans

To report osteoporosis screening utilization rates among Asian American (AsA) populations in the USA. The study found lower than expected DXA screening rates for AsA patients. A better understanding of the barriers and facilitators to AsA osteoporosis screening is needed to improve patient care. Full Article

Soterios Gyftopoulos, Casey E. Pelzl, Madalena Da Silva Cardoso, Juliana Xie, Simona C. Kwon & Connie Y. Chang. 2024. "Bone Density Screening Rates Among Medicare Beneficiaries: An Analysis with a focus on Asian Americans," Skeletal Radiology

Radiologists’ 2021 Quality Reporting and Performance in Medicare’s Merit-Based Incentive Payment System: Analysis by Practice Type

The study shows that radiologists in radiology-only practices score significantly lower in the Centers for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS) in 2021. The researchers found that radiologists in multispecialty practices score higher, but rarely report any radiology-relevant MIPS quality measures, and instead report measures relevant to other specialties. The findings were published in the American Journal of Roentgenology. Full Article

YoonKyung Chung, PhD, Lauren P. Nicola, MD, Chi-Mei Liu, PhD, and Elizabeth Y. Rula, PhD. 2024. "Radiologists’ 2021 Quality Reporting and Performance in Medicare’s Merit-Based Incentive Payment System: Analysis by Practice Type," American Journal of Roentgenology

Decomposition of Medical Imaging Spending Growth Between 2010 and 2021 in the U.S. Employer-Insured Population (Michal Horny)

Medical imaging, identified as a potential driver of unsustainable US health care spending growth, was subject to policies to reduce prices and use in low-value settings. Meanwhile, the Affordable Care Act increased access to preventive services—many involving imaging—for employer-sponsored insurance (ESI) beneficiaries. The researchers used a large insurance claims database to examine imaging spending trends in the ESI population between 2010 and 2021—a period of considerable policy and benefits changes. Full Article

Michal Horný, Daniel Chang, Eric W Christensen, Elizabeth Y Rula, Richard Duszak, Jr. 2024. "Decomposition of Medical Imaging Spending Growth Between 2010 and 2021 in the U.S. Employer-Insured Population (Michal Horny)," Health Affairs Scholar

A Claims-Based Method for Identification and Characterization of Practicing Interventional Radiologists

To propose a research method for identifying “practicing interventional radiologists” using 2 national claims data sets. Full Article

Mikki D. Waid, PhD, Elizabeth Y. Rula, PhD, Matthew Hawkins, MD, Laura Findeiss, MD, Raymond Liu, MD. 2024. "A Claims-Based Method for Identification and Characterization of Practicing Interventional Radiologists," Journal of Vascular and Interventional Radiology (JVIR)