Characteristics of COVID-19 Community Practice Declines in Noninvasive Diagnostic Imaging Professional Work |
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| Institution: | 1. Professor and Vice Chair of Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, and Emory Healthcare, Atlanta, Georgia;2. Founder and CEO of Quinsite, LLC, Chapel Hill, North Carolina;3. School of Economics, Georgia Institute of Technology, Atlanta, Georgia;4. Department of Radiology and Imaging Sciences, Emory University School of Medicine, and Emory Healthcare, Atlanta, Georgia; Division Director, Community Radiology, Atlanta, Georgia;5. Executive Committee Chair, and Clinical Operations Chair, Triad Radiology Associates, Winston Salem, North Carolina;6. Finance Chair and Board Member at Hackensack Meridian Health Partners Clinically Integrated Network; Executive leadership position at Hackensack Radiology Group PA, River Edge, New Jersey;7. Executive Director, Harvey L. Neiman Health Policy Institute, Washington, DC;8. Professor, School of Economics, Director, Health Economics and Analytics Lab (HEAL), Georgia Institute of Technology, Atlanta, Georgia |
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| Abstract: | PurposeThe 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.MethodsUsing imaging metadata from nine community radiology practices across the United States between January 2019 and May 2020, we mapped work relative value unit (wRVU)-weighted stand-alone noninvasive diagnostic imaging service codes to both modality and body region. Weekly 2020 versus 2019 wRVU changes were analyzed by modality, body region, and site of service. Practice share χ2 testing was performed.ResultsAggregate weekly wRVUs ranged from a high of 120,450 (February 2020) to a low of 55,188 (April 2020). During that −52% wRVU nadir, outpatient declines were greatest (−66%). All practices followed similar aggregate trends in the distribution of wRVUs between each 2020 versus 2019 week (P = .96-.98). As a percentage of total all-practice wRVUs, declines in CT (20,046 of 63,992; 31%) and radiography and fluoroscopy (19,196; 30%) were greatest. By body region, declines in abdomen and pelvis (16,203; 25%) and breast (12,032; 19%) imaging were greatest. Mammography (−17%) and abdominal and pelvic CT (−14%) accounted for the largest shares of total all-practice wRVU reductions. Across modality-region groups, declines were far greatest for mammography (−92%).ConclusionsSubstantial COVID-19-related diagnostic imaging work declines were similar across community practices and disproportionately impacted mammography. Decline patterns could facilitate pandemic second wave planning. Overall implications for practice workflows, practice finances, patient access, and payment policy are manifold. |
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| Keywords: | COVID19 imaging utilization work relative value unit |
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