Publications

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)

Trends in Non-Focal Neurological Chief Complaints and CT Angiography Utilization among Adults in the Emergency Department

Prudent imaging use is essential for cost reduction and efficient patient triage. Recent efforts have focused on head and neck CTA in patients with emergent concerns for non-focal neurological complaints, but have failed to demonstrate whether increases in utilization have resulted in better care. The objective of this study was to examine trends in head and neck CTA ordering and determine whether a correlation exists between imaging utilization and positivity rates. Full Article

Grant H. Rigney, Alexander H. King, Janice Chung, Soham Ghoshal, Aditya Jain, Zhuo Shi, Shahaan Razak, Joshua A. Hirsch, Michael H. Lev, Karen Buch & Marc D. Succi. 2024. "Trends in Non-Focal Neurological Chief Complaints and CT Angiography Utilization among Adults in the Emergency Department," Internal and Emergency Medicine

Disparities in Provider Ordering Practices of Image-Guided Interventions and Surgery for Patients With Low Back Pain: A Cohort Study

This JACR study assessed individual- and neighborhood-level sociodemographic factors associating with providers’ ordering of nonpharmacologic treatments for patients with low back pain (LBP), specifically physical therapy, image-guided interventions, and lumbar surgery. Full Article

Miriam E. Peckham, MD, Lubdha M. Shah, MD, MS, Huong D. Meeks, PhD, MStat, MPH, Alison Fraser, MSPH, Carlos Galvao, BS, Ghazaleh Safazadeh, MPH, CPH, Troy A. Hutchins, MD, Yoshimi Anzai, MD, MPH, Julie M. Fritz, PhD, PT, ATC, Jacob Kean, PhD, Ruth C. Carlos, MD, MS. 2024. "Disparities in Provider Ordering Practices of Image-Guided Interventions and Surgery for Patients With Low Back Pain: A Cohort Study," Journal of American College of Radiology (JACR)

The Neiman Imaging Comorbidity Index: Development and Validation in a National Commercial Claims Database

To build the Neiman Imaging Comorbidity Index (NICI), based on variables available in claims datasets, which provides good discrimination of an individual’s chance of receiving advanced imaging (CT, MR, PET), and thus, utility as a control variable in research. Full Article

Casey E. Pelzl, MPH Andrew B. Rosenkrantz, MD Elizabeth Y. Rula, PhD Eric W. Christensen, PhD. 2024. "The Neiman Imaging Comorbidity Index: Development and Validation in a National Commercial Claims Database," Journal of American College of Radiology (JACR)

Radiologists’ Out-of-Network Billing Trends, 2007 to 2021

Given the financial hardships of surprise billing for patients, the aim of this study was to assess the degree to which radiologists effectively participate in commercial insurance networks by examining the trend in the share of radiologists’ imaging claims that are out of network (OON). Full Article

Jay R. Parikh, MD, Alexandra R. Drake, MPH, Mikki D. Waid, PhD, Elizabeth Y. Rula, PhD, Eric W. Christensen, PhD. 2024. "Radiologists’ Out-of-Network Billing Trends, 2007 to 2021," Journal of American College of Radiology (JACR)

Financial Viability of the No Surprises Act Independent Dispute Resolution Process: Radiology and Other Hospital-Based Specialties

The federal No Surprises Act (NSA), designed to eliminate surprise medical billing for out-of-network (OON) care for circumstances beyond patients' control, established the independent dispute resolution (IDR) process to settle clinician-payer payment disputes for OON care. The objective of this study is to assess the fraction of OON claims for which radiologists and other hospital-based specialists can expect to at least break even when challenging payer-determined payments through the NSA IDR process, as a measure of the process's financial viability. Full Article

Eric W. Christensen, PhD, Mikki D. Waid, PhD, Joshua A. Hirsch, MD, Jay R. Parikh, MD, Ali S. Raja, MD, DBA, James P. Rathmell, MD, MBA, and Elizabeth Y. Rula, PhD. 2024. "Financial Viability of the No Surprises Act Independent Dispute Resolution Process: Radiology and Other Hospital-Based Specialties," American Journal of Roentgenology