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. 2020 Nov;17(11):1453-1459.
doi: 10.1016/j.jacr.2020.06.031. Epub 2020 Jul 3.

Characteristics of COVID-19 Community Practice Declines in Noninvasive Diagnostic Imaging Professional Work

Richard Duszak Jr  1 , Jeff Maze  2 , Candice Sessa  3 , Howard B Fleishon  4 , Lauren P Golding  5 , Gregory N Nicola  6 , Danny R Hughes  7
Affiliations

Characteristics of COVID-19 Community Practice Declines in Noninvasive Diagnostic Imaging Professional Work

Richard Duszak Jr et al. J Am Coll Radiol. 2020 Nov.

Abstract

Purpose: 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.

Methods: Using 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.

Results: Aggregate 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%).

Conclusions: Substantial 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.

Keywords: COVID19; imaging utilization; work relative value unit.

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Figures

Fig 1
Fig 1
Percent change in weekly aggregate all-practice 2020 versus 2019 noninvasive diagnostic imaging service work relative value units by site of service.
Fig 2
Fig 2
Overall aggregate work relative value unit (wRVU) changes and percentage work relative value unit changes across all practices during the 2020 week with the largest aggregate decline (week 14) compared with the same week in 2019 for noninvasive diagnostic imaging by modality (top) and body part (bottom).
Fig 3
Fig 3
Overall aggregate work relative value unit (wRVU) changes and percentage work relative value unit changes across all practices during the 2020 week with the largest aggregate decline (week 14) compared with the same week in 2019 for noninvasive diagnostic imaging for each Neiman Imaging Types of Service modality-region group by site of service. ED = emergency department.
Fig 4
Fig 4
Share of aggregate weekly 2020 work relative value unit by site of service.
See this image and copyright information in PMC

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