Skip to archived articles

The mission of the Harvey L. Neiman Health Policy Institute® is to establish foundational evidence for health policy and radiology practice that promotes the effective and efficient use of health care resources and improves patient care.

Access & Quality

Racial and Ethnic Disparities in the Use of Prostate Magnetic Resonance Imaging Following an Elevated Prostate-Specific Antigen Test

In this cohort study of 794,809 commercially insured men from 2011 to 2017 undergoing a prostate-specific antigen test, Black and Hispanic patients were significantly less likely than White patients to undergo prostate magnetic resonance imaging after receiving an elevated test score. Full Article

Nino Abashidze, PhD, Chad Stecher, PhD, Andrew B. Rosenkrantz, MD, MPA, Richard Duszak Jr, MD, Danny R. Hughes, PhD. 2021. "Racial and Ethnic Disparities in the Use of Prostate Magnetic Resonance Imaging Following an Elevated Prostate-Specific Antigen Test," JAMA Network Open

Secondary Interpretations of Diagnostic Imaging Examinations: Patient Liabilities and Out-of-Pocket Costs

Secondary interpretations of diagnostic imaging examinations are increasingly performed to improve care for complex patients. This study sought to determine associated patient-billed liabilities and out-of-pocket payments and to identify patient and imaging study characteristics that correlate with higher patient bills and out-of-pocket payments. Full Article

Sean P. Doyle, MD, Richard Duszak Jr, MD, Marta E. Heilbrun, MD, Amit M. Saindane, MD, MBA, Gelareh Sadigh, MD. 2021. "Secondary Interpretations of Diagnostic Imaging Examinations: Patient Liabilities and Out-of-Pocket Costs," Journal of American College of Radiology (JACR)

Comparison of Radiologists and Other Specialists in the Performance of Lumbar Puncture Procedures Over Time

Lumbar punctures may be performed by many different types of health care providers. This study evaluates the percentages of lumbar punctures performed by radiologists-versus-nonradiologist providers, including changes with time and discrepancies between specialties. Full Article

D.R. Johnson, MD, Mikki Waid, PhD, Danny R. Hughes, PhD, Andrew B. Rosenkrantz, MD, Richard Duszak, MD. 2021. "Comparison of Radiologists and Other Specialists in the Performance of Lumbar Puncture Procedures Over Time," American Journal of Neuroradiology

Radiologist Characteristics Associated with Interpretive Performance of Screening Mammography: A National Mammography Database (NMD) Study

Across radiologists nationally, geography, breast subspecialization, and performance of diagnostic mammography are associated with better screening mammography performance; performance of breast US is associated with lower performance. Factors affecting radiologists’ performance in screening mammography interpretation remain poorly understood. The purpose of this study it to identify radiologists characteristics that affect screening mammography interpretation performance. Full Article

Cindy Lee, MD, Linda Moy, MD, Hughes R. Danny, PhD, Dan Golden, Mythreyi Bhargavan-Chatfield, PhD, Jennifer Hemingway, MS, Agnieszka Geras, Richard Duszak, MD, Andrew Rosenkrantz, MD. 2021. "Radiologist Characteristics Associated with Interpretive Performance of Screening Mammography: A National Mammography Database (NMD) Study," Radiology

Longitudinal Changes of Financial Hardship in Patients with Multiple Sclerosis

To measure the longitudinal changes in three domains of financial hardship (i.e., financial worry, cost-related care non-adherence, material hardship) in patients with MS. Full Article

Gelareh Sadigh, MD, Jeffrey Switchenko, MD, Neil Lava, MD, Richard Duszak Jr, MD, Elizabeth A. Krupinski, MD, Carolyn C. Meltzer, MD, Ruth C. Carlos, MD. 2021. "Longitudinal Changes of Financial Hardship in Patients with Multiple Sclerosis," Multiple Sclerosis

Developmental Hip Dysplasia and Hip Ultrasound Frequency in a Large American Payer Database

Developmental dysplasia of the hip (DDH) is an important contributor to musculoskeletal morbidity, but effective strategies to screen for DDH remain controversial. The current utilization of hip ultrasound (US) screening for DDH in the United States is not defined. This study utilized Optum's de-identified Clinformatics® Data Mart, a large commercial and Medicare Advantage claims database. Full Article

Andrew J. Degnan, MD, Jennifer Hemingway, MS, Hansel Otero, Danny R. Hughes, PhD. 2021. "Developmental Hip Dysplasia and Hip Ultrasound Frequency in a Large American Payer Database," Clinical Imaging

U.S. Preventive Services Task Force Update and Computed Tomography for Colorectal Cancer Screening Among Privately Insured Population

The Affordable Care Act of 2010 mandated private health plans to fully cover the services recommended by the U.S. Preventive Services Task Force. In June 2016, the Task Force added computed tomography colonography to its list of recommended tests for colorectal cancer screening. This study evaluates the association among the updated recommendation, patient cost-sharing obligations, and the uptake of colorectal cancer screening through computed tomography colonography in the privately insured population. Full Article

Steven Chen, MSPH, Courtney C. Moreno, MD, Richard Duszak Jr., MD, Michal Horny, PhD. 2021. "U.S. Preventive Services Task Force Update and Computed Tomography for Colorectal Cancer Screening Among Privately Insured Population," American Journal of Preventative Medicine

Predicted Cost Savings Achieved by the Radiology Support, Communication and Alignment Network from Reducing Medical Imaging Overutilization in the Medicare Population

The Radiology Support, Communication and Alignment Network (R-SCAN) is a quality improvement program through which patients, referring clinicians, and radiologists collaborate to improve imaging appropriateness based on Choosing Wisely recommendations and ACR Appropriateness Criteria. R-SCAN was shown previously to increase the odds of obtaining an appropriate, higher patient or diagnostic value, imaging study. In the current study, the researchers aimed to estimate the potential imaging cost savings associated with R-SCAN use for the Medicare population. Full Article

Max Wintermark, MD, MAS, MBA , Andrew B. Rosenkrantz, MD, Paymon G. Rezaii, MS, Nancy Fredericks, MBA, Laura Chaves Cerdas, MS, Judy Burleson, MHSA, G. Rebecca Haines, MSM, CPXP, Mythreyi Chatfield, PhD William T. Thorwarth Jr., MD, Richard Duszak Jr., MD, Danny R. Hughes, PhD. 2021. "Predicted Cost Savings Achieved by the Radiology Support, Communication and Alignment Network from Reducing Medical Imaging Overutilization in the Medicare Population," Journal of American College of Radiology (JACR)

Disparities in the Use of Emergency Department Advanced Imaging in Medicare Beneficiaries

The purpose of this study was to assess potential disparities in the utilization of advanced imaging during emergency department (ED) visits. This retrospective study was conducting using 5% Research Identifiable Files. All CT and MRI (together defined as “advanced imaging”) examinations associated with ED visits in 2015 were identified for continuously enrolled Medicare beneficiaries. Among Medicare beneficiaries receiving care in U.S. EDs, significant disparities exist in advanced imaging utilization. Although imaging appropriateness was not investigated, these findings suggest inequity. Further research is necessary to understand why consistent health benefits do not translate into consistent imaging access among risk-adjusted ED patients. Full Article

Tarek N. Hanna, MD, Eric Friedberg, MD, Ivan M. Dequesada, MD, Laura Chaves, MPP, Robert Pyatt, MD, Richard Duszak, Jr., MD, Danny R. Hughes, PhD. 2021. "Disparities in the Use of Emergency Department Advanced Imaging in Medicare Beneficiaries," American Journal of Roentgenology

January 11, 2021

Predicted Cost Savings Achieved by the Radiology Support, Communication and Alignment Network from Reducing Medical Imaging Overutilization in the Medicare Population

The Radiology Support, Communication and Alignment Network (R-SCAN) is a quality improvement program through which patients, referring clinicians, and radiologists collaborate to improve imaging appropriateness based on Choosing Wisely recommendations and ACR Appropriateness Criteria. In the current study, we aimed to estimate the potential imaging cost savings associated with R-SCAN use for the Medicare population. View Infographic