Current approaches may be underselling interventional radiology’s impact on U.S. medicine, according to new research published Monday.
IRs are inconsistently defined in health research and underrepresented by specialty designation in claims data. Experts with the Neiman Health Policy Institute and other institutions are proposing a new method that would better capture the broadening reach of “arguably the most poorly understood field of medicine.”
“Prior to the creation of the IR residency, [diagnostic radiologists] obtained competency in some IR procedures, and many continue to perform IR work. The overlap in services rendered across specialties, both within and outside of radiology, creates a challenge for identifying IR physicians using available payer data sources,” Mikki D. Waid, PhD, senior research fellow with the policy institute, and co-authors wrote March 4 in the Journal of Vascular and Interventional Radiology [1]. “Accordingly, methods for identification of practicing IRs for health services research have been inconsistent, presenting a barrier to reproducible health services research in this field.”
For their study, Waid et al. analyzed claims from both Medicare Part B and Optum’s commercial database, spanning 2015 to 2019. They used the information to rank radiologists’ interventional work as a percent of total billed RVUs. When using a 10% IR-work threshold, only about 24% of practicing radiologists were identified as interventional specialists. However, at a 50% IR-work threshold, the number increased to 42%, and a 90% cutoff upped the number of designated IRs to 47.5%.
Average percentage of interventional-related work was 45%, 84% and 96% of total work RVUs using the 10%, 50% and 90% thresholds, respectively. Using these percentages on the Optum commercial claims data meant that about 21% of practice radiologists could be defined as IRs (at 10%), 35% of IRs (50%) and more than 38% (at 90%). This shift also led to the specialty representing a greater share of evaluation and management work RVUs, the authors noted. Practicing interventional radiologists were more likely to be male, live in a metropolitan area and in the earlier part of their career, regardless of threshold.
“Most radiologists performing IR-related work are designated in claims data as DRs, indicating insufficiency of specialty designation for IR identification,” Waid and co-authors concluded. “The proposed method to identify practicing IRs by percent IR-related work effort could improve generalizability and comparability across claims-based IR studies.”
Read more in JVIR at the link below.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.