News | Business | July 06, 2017

Claims System Could Lead to Private Practice Radiology Subspecialty Quality Metrics

New study using Medicare claims data identifies radiologist subspecialties more accurately than current system

Claims System Could Lead to Private Practice Radiology Subspecialty Quality Metrics

July 6, 2017 — A new Harvey L. Neiman Health Policy Institute study shows that a claims-based system used to subspecialty classify academic radiologists accurately identifies self-designated subspecialties for the approximately half of included private practice radiologists who have a subspecialized practice. The study is published online in the Journal of the American College of Radiology (JACR).

“Medicare is increasingly looking to develop specialty- and subspecialty-specific quality metrics that are as relevant and meaningful as possible to individual physicians, reflecting the diversity of physician practice,” noted lead author Andrew Rosenkrantz, M.D., MPA, an associate professor of radiology at NYU Langone Medical Center and a Neiman Institute affiliate research fellow. “There is currently no objective and reproducible method for determining radiologists’ subspecialties.”

Rosenkrantz and his colleagues looked at the websites of the 100 largest U.S. radiology private practices to identify 1,271 radiologists self-identified with a single subspecialty. Concordance of existing Medicare radiology subspecialty provider codes was first assessed. Next, using an academic practice piloted classification approach based on the Neiman Imaging Types of Service (NITOS) coding platform, the percentage of subspecialty work relative value units (wRVUs) from Medicare claims data were used to assign each radiologist a unique subspecialty.

The researchers found that the NITOS-based system mapped a median 51.9 percent of private practice radiologists’ wRVUs to self-identified subspecialties. The 50 percent NITOS-based wRVU threshold previously established for academic radiologists correctly assigned subspecialties to 48.8 percent of private practice radiologists, but incorrectly categorized 2.9 percent. Practice patterns of the remaining 48.3 percent were sufficiently varied such that no single subspecialty assignment was possible.

“Unambiguously classifying the subspecialties of private practice radiologists has presented a historic challenge given varied practice patterns and the fact that many subspecialists spend a considerable fraction of their time outside of their primary practice areas,” said Richard Duszak, M.D., FACR, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University and senior affiliate research fellow at the Neiman Institute. “Existing CMS [Centers for Medicare and Medicaid Services] provider subspecialty codes match poorly with private practice radiologists’ self-identified subspecialties and perform notably worse in such identification than in the academic practice setting. As new payment models increasingly focus on specialty- and subspecialty-specific performance measures, claims-based identification methodologies should be further explored to ensure that radiologists are scored and paid using the most appropriate practice-relevant metrics.”

“Our work validates the ability of a claims-based system for determining radiologists’ subspecialty in the private practice setting, with an error rate of less than 5 percent. This classification system could be used for such quality-based payment systems, as well as to enable future research studies characterizing the national radiologist workforce,” added Rosenkrantz.

For more information:

Related Content

News | Business | March 08, 2018
Scranton Gillette Communications’ Imaging Technology News (ITN) was recently named a 2018 Azbee Award finalist in five...
Imaging agent helps predict success of lung cancer therapy
News | Oncology Diagnostics | March 08, 2018
March 8, 2018 – Doctors contemplating the best therapy for...
Fysicon announced its acquisition by Canon Medical Systems Corporation.
News | Business | March 07, 2018
Fysicon announced its acquisition by Canon Medical Systems Corporation. Linda Elberse, CEO of Fysicon, stated: "Being...
Designed to optimize workflow, IntelliSpace Portal supports consistency across applications.
Sponsored Content | Case Study | Imaging | March 06, 2018
As one of the largest Catholic, not-for-profit healthcare systems in the United States, St. Louis-based SSM Health has...
ECR 2018 Spotlights Artificial Intelligence and Current Radiology Trends
News | Interventional Radiology | February 21, 2018
The European Congress of Radiology (ECR) announced the theme of its 2018 annual meeting, Feb. 28-March 4 in Vienna...
Radiography Education Enrollment Shows Marginal Rise in 2017
News | Business | February 15, 2018
Directors of radiography educational programs report the number of enrolled students increased slightly in 2017, while...
Sponsored Content | Videos | Imaging | February 15, 2018
David Widmann, president and CEO of Konica Minolta, looks at what the future of healthcare can bring to its customers,...
Sponsored Content | Videos | Imaging | February 15, 2018
Kiyotaka Fujii, global healthcare senior executive officer and president of Konica Minolta, discusses the company's...
AHRA and Canon Medical Systems Announce 2017 Putting Patients First Grant Winners
News | Patient Engagement | February 14, 2018
The Association for Medical Imaging Management (AHRA) and Canon Medical Systems recently announced the tenth annual...
Patients Lack Information About Imaging Exams
News | Patient Engagement | February 14, 2018
Patients and their caregivers desire information about upcoming imaging examinations, but many are not getting it,...
Overlay Init