This study characterize national trends in oncologic imaging (OI) utilization. This retrospective cross-sectional study used 2004 and 2016 CMS 5% Carrier Claims Research Identifiable Files. Radiologist-performed, primary noninvasive diagnostic imaging examinations were identified from billed Current Procedural Terminology codes; CT, MRI, and PET/CT examinations were categorized as “advanced” imaging. OI examinations were identified from imaging claims’ primary International Classification of Diseases-9 and International Classification of Diseases-10 codes. Imaging services were stratified by academic practice status and place of service. State-level correlations of oncologic advanced imaging utilization (examinations per 1,000 beneficiaries) with cancer prevalence and radiologist supply were assessed by Spearman correlation coefficient.OI usage varied between practice settings. Although the percentage of advanced OI done in academic settings nearly
doubled from 2004 to 2016, the majority remained in nonacademic practices. Full Article
Andrew B. Rosenkrantz, MD, Laura Chaves Cerdas, MS, Danny R. Hughes, PhD, Michael P. Recht, MD, Sharyl J. Nass, PhD, Hedvig Hricak, MD, PhD. 2020. "National Trends in Oncologic Diagnostic Imaging," Journal of American College of Radiology (JACR): 1116 - 1122.
The operational and financial impact of the widespread coronavirus disease 2019 (COVID-19) curtailment of imaging services on radiology practices is unknown. We aimed to characterize recent COVID-19-related community practice noninvasive diagnostic imaging professional work declines. The authors used imaging metadata from nine community radiology practices across the United States between January 2019 and May 2020, and mapped work relative value unit (wRVU)-weighted stand-alone noninvasive diagnostic imaging service codes to both modality and body region. Full Article
Richard Duszak Jr, MD, Jeff Maze, MB, Candice Sessa, MS, Howard B. Fleishon, MD, Lauren P. Golding, MD, Gregory N. Nicola, MD, Danny R. Hughes, Ph. 2020. "Characteristics of Coronavirus Disease 2019 (COVID-19) Community Practice Declines in Noninvasive Diagnostic Imaging Professional Work," Journal of American College of Radiology (JACR)
Bundled payments have been touted as mechanisms to optimize quality and costs. A recent feasibility study evaluating
bundled payments for screening mammography episodes predated widespread adoption of digital breast tomosynthesis (DBT). We
explore a similar model reflecting emerging acceptance of DBT in breast cancer screening.
Methods: Using 4-year data for 59,094 screening episodes from two large facilities within a large academic health system, we utilized published methodology to calibrate Medicare national allowable reference prices for women undergoing screening mammography before and after practice-wide implementation of DBT. Full Article
Margaret M. Fleming, MD, MS, Danny R. Hughes, PhD, Lauren P. Golding, MD, Geraldine B. McGinty, MD, MBA, Dan MacFarlane, BS, CPA, Richard Duszak Jr, MD. 2019. "Digital Breast Tomosynthesis Implementation: Considerations for Emerging Breast Cancer Screening Bundled Payment Models," Journal of American College of Radiology (JACR), 16(7)
The toll of burnout on healthcare is significant and associated with physician depression and medical errors. The objective of this study it to assess the prevalence and risk factors for burnout among neurointerventionalists. Full Article
Kyle M Fargen, Adam S Arthur, Thabele Leslie-Mazwi, Rebecca M Garner, Carol A Aschenbrenner, Stacey Q Wolfe, Sameer A Ansari, Guilherme Dabus, Alejandro Spiotta, Maxim Mokin, Italo Linfante, J Mocco, Joshua A Hirsch. 2019. "Survey Measures Burnout Among Neurointerventionalists," Journal of NeuroInterventional Surgery
The aim of this study was to assess the potential impact of ACR evidence-based advocacy on radiologist professional reimbursement from individual-provider CMS multiple-procedure payment reduction (MPPR) initiatives. Full Article
Sadigh, G., Hughes, D.R., Wang, W., Allen, B., McGinty, G., Silva, E., Duszak, R. 2017. "Radiologist Professional Payments After Mitigation of CMS’s Multiple-Procedure Payment Reduction Initiatives," Journal of the American College of Radiology
This paper suggests that patient-focused physician models provide a compelling opportunity for radiologists to demonstrate and be rewarded for their unique contributions toward patient care, and may foster greater radiologist participation in APMs under MACRA. Full Article
Rosenkrantz, A.B., Nicola G.N., Allen, B., Hughes, D.R., and Hirsch, J.A. 2017. "MACRA, Alternative Payment Models, and the Physician-Focused Payment Model: Implications for Radiology," Journal of the American College of Radiology
This report found that CMS’ proposed criteria for special considerations in new payment models would result in many radiologists being evaluated using measures not reflective of their practice. Full Article
Rosenkrantz A.B., Hirsch J.A., Allen B. Jr., Wang W., Hughes D.R., Nicola G. 2017. "The Proposed MACRA/MIPS Threshold for Patient-Facing Encounters: What It Means for Radiologists," Journal of the American College of Radiology, 14(3): 308 - 315.
This report provides an overview of CMS’ proposal for implementing MACRA legislation via the new QPP, paying specific attention to the implications and imperatives for radiologists under MIPS. Full Article
Rosenkrantz, A.B., Nicola G.N., Allen, B., Hughes, D.R., and Hirsch, J.A. 2017. "MACRA, MIPS, and the New Medicare Quality Payment Program: An Update for Radiologists," Journal of the American College of Radiology, 14(3): 316 - 323.
This paper specifically studies the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs) and determines how this incentive program affects computed tomography (CT) use, and how it could be redesigned to minimize unnecessary CT scans. Full Article
Zhang, H., Wernz, C., Hughes, D.R. 2016. "Modeling and Designing Health Care Payment Innovations for Medical Imaging," Health Care Management Science
