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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.

Utilization

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

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

March 12, 2024

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

This 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. Authors: Miriam E. Peckham, MD, Lubdha M. Shah, MD, MS, Huong D. Meeks, PhD, MStat, MPH, Alison Fraser, MSPH, Carlos Galvao, BS, Ghazaleh Safazadeh, MPH, View Infographic

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)

Projected Growth in FDA-Approved Artificial Intelligence Products Given Venture Capital Funding

Medical imaging accounts for 85% of digital health’s venture capital funding. As funding grows, it is expected that artificial intelligence (AI) products will increase commensurately. The study’s objective is to project the number of new AI products given the statistical association between historical funding and FDA-approved AI products. Full Article

Nicole K. McNabb, BS Eric W. Christensen, PhD Elizabeth Y. Rula, PhD Laura Coombs, PhD Keith Dreyer, DO, PhD Christoph Wald, MD Christopher Treml, MS. 2023. "Projected Growth in FDA-Approved Artificial Intelligence Products Given Venture Capital Funding," Journal of American College of Radiology (JACR)

Budget Neutrality and Medicare Physician Fee Schedule Reimbursement Trends for Radiologists, 2005 to 2021

The Medicare program, by law, must remain budget neutral. Increases in volume or relative value units (RVUs) for individual services necessitate declines in either the conversion factor or assigned RVUs for other services for budget neutrality. This study aimed to assess the contribution of budget neutrality on reimbursement trends per Medicare fee-for-service beneficiary for services provided by radiologists. Full Article

Eric W. Christensen, PhD Gregory N. Nicola, MD Elizabeth Y. Rula, PhD Lauren P. Nicola, MD Jennifer Hemingway, MS Joshua A. Hirsch, MD. 2023. "Budget Neutrality and Medicare Physician Fee Schedule Reimbursement Trends for Radiologists, 2005 to 2021," Journal of American College of Radiology (JACR)

Overall Lung Cancer Screening Rates Low

A recent study found overall estimated screening rates of 1.75% for people covered by commercial insurance, 3.37% for those covered by traditional Medicare (fee-for-service), and 4.56% for those covered by Medicare Advantage plans. Full Article

Mary Beth Nierengarten, Elizabeth Rula, PhD. 2023. "Overall Lung Cancer Screening Rates Low," Cancer

Sociodemographic Factors and Screening CT Colonography Use Among Medicare Beneficiaries

Approximately one-third of the eligible U.S. population have not undergone guideline-compliant colorectal cancer screening. Guidelines recognize various screening strategies, to increase adherence. CMS provides coverage for all recommended screening tests except for CT colonography. The objective of this study is to compare CTC and other CRC screening tests in terms of associations of utilization with income, race and ethnicity, and urbanicity, in Medicare fee-for-service beneficiaries. Full Article

Eric W. Christensen, PhD, Pina C. Sanelli, MD, MPH, Elizabeth Y. Rula, PhD, Kevin J. Chang, MD, Courtney C. Moreno, MD, David H. Bruining, MD, and Judy Yee, MD. 2023. "Sociodemographic Factors and Screening CT Colonography Use Among Medicare Beneficiaries," American Journal of Roentgenology