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Article ; Online: How Radiologists Are Paid: An Economic History, Part I: The Fight for Independent Billing.

Levy, Frank / Rosen, Max P

Journal of the American College of Radiology : JACR

2020 Volume 17, Issue 6, Page(s) 693–697

Abstract: In the first article in a four-part work, the authors review the economic history of how radiologists are paid, from the fight for independent billing in the 1960s to the impact of advanced imaging technologies on radiologists' incomes in the 1980s to ... ...

Abstract	In the first article in a four-part work, the authors review the economic history of how radiologists are paid, from the fight for independent billing in the 1960s to the impact of advanced imaging technologies on radiologists' incomes in the 1980s to the "bubble years" of the 1990s and to the end of the bubble in the first decade of the 21 century. The authors begin in this first part with the connections among a radiologist from Arkansas, a congressman, and the passage of Medicare, the program that gave radiologists the right to bill independently and gave the federal government a big role in health care spending.
MeSH term(s)	Aged ; Arkansas ; Federal Government ; Humans ; Medicare ; Radiologists ; Salaries and Fringe Benefits ; United States
Language	English
Publishing date	2020-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2020.02.014
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Article ; Online: How Radiologists Are Paid: An Economic History, Part III: The Bubble Years.

Levy, Frank / Rosen, Max P

Journal of the American College of Radiology : JACR

2020 Volume 17, Issue 8, Page(s) 984–989

Abstract: With the collapse of the Clinton health care reforms, advanced imaging entered an economic bubble. Between 1995 and 2006, the number of CT and MRI studies almost tripled, from 21 million to 62 million and from 9.1 to 26.6 million, respectively. The ... ...

Abstract	With the collapse of the Clinton health care reforms, advanced imaging entered an economic bubble. Between 1995 and 2006, the number of CT and MRI studies almost tripled, from 21 million to 62 million and from 9.1 to 26.6 million, respectively. The increase reflected increases in both the number of scanners and the number of scans generated per CT or MRI scanner. Without restrictions, the profits generated by CT and MR ownership inevitably spread from hospitals first to imaging centers and later to individual physicians' offices and led to potential for conflict of interest and self-referral. During this time, the increase in radiologists' efficiency was fueled by the conversion from "film" to digitized images and PACS. In conjunction with increased volume and efficiency, radiologists' compensation increased throughout the 1990s.
MeSH term(s)	Humans ; Magnetic Resonance Imaging ; Ownership ; Radiologists ; Referral and Consultation ; Salaries and Fringe Benefits
Language	English
Publishing date	2020-03-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2020.02.012
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Article ; Online: How Radiologists Are Paid: An Economic History, Part II: Advanced Imaging and Radiologists' Incomes.

Levy, Frank / Rosen, Max P

Journal of the American College of Radiology : JACR

2020 Volume 17, Issue 7, Page(s) 833–838

Abstract: The advent of the CT scanner in the early 1970s removed much, if not all, of the morbidity and discomfort previously associated with diagnostic imaging studies. Throughout the 1970s and 1980s, advances in CT technology allowed radiologists to scan " ... ...

Abstract	The advent of the CT scanner in the early 1970s removed much, if not all, of the morbidity and discomfort previously associated with diagnostic imaging studies. Throughout the 1970s and 1980s, advances in CT technology allowed radiologists to scan "better and faster." The professional fee for reading a CT study was higher than for reading a radiograph, an uncontroversial policy. But estimating the technical fee for using CT (and later MR) raised problems that would persist for at least 30 years. Consistently generous technical fees created potential incentives to create and fill advanced imaging capacity and contributed to the emerging problem of health care inflation.
MeSH term(s)	Diagnostic Imaging ; Humans ; Income ; Radiologists ; Salaries and Fringe Benefits
Language	English
Publishing date	2020-03-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2020.02.013
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Article ; Online: How Radiologists Are Paid: An Economic History, Part IV: End of the Bubble.

Levy, Frank / Rosen, Max P

Journal of the American College of Radiology : JACR

2020 Volume 17, Issue 9, Page(s) 1080–1085

Abstract: During the first decade of the 21st century, the imaging bubble began to burst. The combination of digitized images, the DICOM standard, and affordable PACS sharply increased radiologists' productivity but also allowed an imaging study to be read from ... ...

Abstract	During the first decade of the 21st century, the imaging bubble began to burst. The combination of digitized images, the DICOM standard, and affordable PACS sharply increased radiologists' productivity but also allowed an imaging study to be read from anywhere, creating the field of teleradiology and increased competition for radiologists. Increasing numbers of insurers contracted with radiology benefits managers to help control radiology utilization, and the Deficit Reduction Act of 2005 mandated spending cuts across the government. Consolidation of multiple Current Procedural Terminology codes and the reassessment of calculations used to estimate the utilization of a CT or an MRI scanner exerted additional downward pressure on radiology reimbursements. All of these factors, combined with more radiologists completing residency and the delayed retirement of older radiologists after the 2008 financial crisis, brought the imaging bubble to an end.
MeSH term(s)	Current Procedural Terminology ; Humans ; Internship and Residency ; Radiologists/economics ; Radiology ; Salaries and Fringe Benefits ; Teleradiology
Language	English
Publishing date	2020-03-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2020.02.016
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Article ; Online: Computers, conversation, utilization, and commoditization: the 2008 Herbert Abrams Lecture.

Levy, Frank

AJR. American journal of roentgenology

2009 Volume 192, Issue 5, Page(s) 1375–1381

MeSH term(s)	Commodification ; Computers ; Decision Support Techniques ; Health Care Sector/trends ; Health Services Needs and Demand/trends ; Humans ; Medicare/economics ; Medicine/trends ; Quality of Health Care ; Radiology/economics ; Radiology/trends ; Specialization ; Teleradiology/economics ; Teleradiology/trends ; United States
Language	English
Publishing date	2009-05
Publishing country	United States
Document type	Addresses
ZDB-ID	82076-3
ISSN	1546-3141 ; 0361-803X ; 0092-5381
ISSN (online)	1546-3141
ISSN	0361-803X ; 0092-5381
DOI	10.2214/AJR.08.2063
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Article ; Online: Computers and the supply of radiology services: anatomy of a disruptive technology.

Levy, Frank

Journal of the American College of Radiology : JACR

2008 Volume 5, Issue 10, Page(s) 1067–1072

Abstract: Over the next decade, computers will augment the supply of radiology services at a time when reimbursement rules are likely to tighten. Increased supply and slower growing demand will result in a radiology market that is more competitive, with less ... ...

Abstract	Over the next decade, computers will augment the supply of radiology services at a time when reimbursement rules are likely to tighten. Increased supply and slower growing demand will result in a radiology market that is more competitive, with less income growth, than the market of the past 15 years.
MeSH term(s)	Biotechnology/economics ; Delivery of Health Care/economics ; Delivery of Health Care/statistics & numerical data ; Delivery of Health Care/utilization ; Income/statistics & numerical data ; Models, Economic ; Radiology/economics ; Radiology Information Systems/economics ; Radiology Information Systems/utilization ; Teleradiology/economics ; Teleradiology/utilization ; United States
Language	English
Publishing date	2008-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2008.05.022
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Article: Early diagnosis of cardiomyopathies by cardiac magnetic resonance. Overview of the main criteria.

Sozzi, Fabiola B / Iacuzio, Laura / Belmonte, Marta / Schiavone, Marco / Bursi, Francesca / Gherbesi, Elisa / Levy, Frank / Canetta, Ciro / Carugo, Stefano

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

2022 Volume 92, Issue 4

Abstract: Cardiomyopathies (CMPs) are diseases of the heart muscle. They include a variety of myocardial disorders that manifest with various structural and functional phenotypes and are frequently genetic. Myocardial disease caused by known cardiovascular causes ( ...

Abstract	Cardiomyopathies (CMPs) are diseases of the heart muscle. They include a variety of myocardial disorders that manifest with various structural and functional phenotypes and are frequently genetic. Myocardial disease caused by known cardiovascular causes (such as hypertension, ischemic heart disease, or valvular disease) should be distinguished from CMPs for classification and management purposes. Identification of various CMP phenotypes relies primarily upon echocardiographic evaluation. In selected cases, cardiac magnetic resonance imaging (CMR) or computed tomography may be useful to identify and localize fatty infiltration, inflammation, scar/fibrosis, focal hypertrophy, and better visualize the left ventricular apex and right ventricle. CMR imaging has emerged as a comprehensive tool for the diagnosis and follow-up of patients with CMPs. The accuracy and reproducibility in evaluating cardiac structures, the unique ability of non-invasive tissue characterization and the lack of ionizing radiation, make CMR very attractive as a potential "all-in-one technique". Indeed, it provides valuable data to confirm or establish the diagnosis, screen subclinical cases, identify aetiology, establish the prognosis. Additionally, it provides information for setting a risk stratification (based on evaluation of proved independent prognostic factors as ejection fraction, end-systolic-volume, myocardial fibrosis) and follow-up. Last, it helps to monitor the response to the therapy. In this review, the pivotal role of CMR in the comprehensive evaluation of patients with CMP is discussed, highlighting the key features guiding differential diagnosis and the assessment of prognosis.
MeSH term(s)	Humans ; Reproducibility of Results ; Cardiomyopathies/diagnostic imaging ; Magnetic Resonance Imaging/methods ; Fibrosis ; Magnetic Resonance Spectroscopy/adverse effects ; Early Diagnosis ; Cytidine Monophosphate ; Prognosis ; Predictive Value of Tests
Chemical Substances	Cytidine Monophosphate (F469818O25)
Language	English
Publishing date	2022-04-11
Publishing country	Italy
Document type	Review ; Journal Article
ZDB-ID	1160940-0
ISSN	1122-0643 ; 1120-0391
ISSN	1122-0643 ; 1120-0391
DOI	10.4081/monaldi.2022.2151
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Article ; Online: Self-stigma, insight, and family burden among Israeli mothers of people with serious mental illness: Ethno-national considerations.

Zisman-Ilani, Yaara / Hasson-Ohayon, Ilanit / Levy-Frank, Itamar / Tuval-Mashiach, Rivka / Roe, David

Transcultural psychiatry

2017 Volume 54, Issue 3, Page(s) 423–441

Abstract: The current cross-sectional study investigated and compared the associations between insight, self-stigma, and family burden among Jewish and Arab mothers of an adult son or daughter with serious mental illness (SMI) in Israel. A total of 162 Israeli ... ...

Abstract	The current cross-sectional study investigated and compared the associations between insight, self-stigma, and family burden among Jewish and Arab mothers of an adult son or daughter with serious mental illness (SMI) in Israel. A total of 162 Israeli mothers of a person with SMI participated in the study; 95 were Jewish (58.6%), and 67 were Arab (41.4%). Insight, self-stigma, and family burden scales were administered. Jewish mothers reported higher levels of insight into their son's or daughter's illness and reported greater family burden compared to Arab mothers. No significant differences in self-stigma scores were found between Jewish and Arab mothers. The pattern of associations between insight, self-stigma, and burden differed between Jewish and Arab mothers. Self-stigma was found to mediate the relationship between insight and burden among Jewish mothers but not among Arab mothers. Ethno-national affiliation should be taken into consideration regarding how family members conceptualize and experience mental illness, as this might affect care.
Language	English
Publishing date	2017-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1378978-8
ISSN	1461-7471 ; 1363-4615
ISSN (online)	1461-7471
ISSN	1363-4615
DOI	10.1177/1363461517703022
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Article ; Online: Percutaneous closure of a paravalvular prosthetic mitral leak complicated by need for acute hemodialysis.

Sozzi, Fabiola / Hugues, Nicolas / Schiavone, Marco / Levy, Frank / Civaia, Filippo / Iacuzio, Laura / Rossi, Philippe / Carugo, Stefano / Bourlon, Francois / Eker, Armand

Journal of clinical ultrasound : JCU

2021 Volume 50, Issue 2, Page(s) 172–175

Abstract: A case of a severe paravalvular mechanical mitral prosthesis leak (PVL) in a high-risk surgical patient, complicated with acute heart failure at presentation is described. Considering the high surgical risk and the specific echocardiographic features ... ...

Abstract	A case of a severe paravalvular mechanical mitral prosthesis leak (PVL) in a high-risk surgical patient, complicated with acute heart failure at presentation is described. Considering the high surgical risk and the specific echocardiographic features that would prevent the interventional cardiologist to have a direct access to the PVL with a traditional vascular plug or duct occluder, a percutaneous PVL closure with an Amplatzer-Amulet (Abbott, Abbott Park, Illinois, United States) LAA device (28 mm) was chosen for the contiguity of the PVL to the left atrial appendage (LAA). A new-onset hemolysis post-PVL closure and severe renal failure requiring hemodialysis occurred after the procedure, treated with surgical device removal and leak suture. To the best of our knowledge, this is the first case that describes the attempt to close a PVL, contiguous to the LAA, using the Amulet device. The attempt to close a PVL with these features with an Amplatzer-Amulet device, although promising, does not appear completely safe to reach the goal, as in our case. In our opinion, the most important reasons are that specific technical recommendations and broad experiences are lacking. Indeed, specific outcomes of this kind of approach are, to date, still unknown.
Language	English
Publishing date	2021-09-04
Publishing country	United States
Document type	Case Reports
ZDB-ID	189393-2
ISSN	1097-0096 ; 0091-2751
ISSN (online)	1097-0096
ISSN	0091-2751
DOI	10.1002/jcu.23059
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Article ; Online: The sharp slowdown in growth of medical imaging: an early analysis suggests combination of policies was the cause.

Lee, David W / Levy, Frank

Health affairs (Project Hope)

2012 Volume 31, Issue 8, Page(s) 1876–1884

Abstract: The growth in the use of advanced imaging for Medicare beneficiaries decelerated in 2006 and 2007, ending a decade of growth that had exceeded 6 percent annually. The slowdown raises three questions. Did the slowdown in growth of imaging under Medicare ... ...

Abstract	The growth in the use of advanced imaging for Medicare beneficiaries decelerated in 2006 and 2007, ending a decade of growth that had exceeded 6 percent annually. The slowdown raises three questions. Did the slowdown in growth of imaging under Medicare persist and extend to the non-Medicare insured? What factors caused the slowdown? Was the slowdown good or bad for patients? Using claims file data and interviews with health care professionals, we found that the growth of imaging use among both Medicare beneficiaries and the non-Medicare insured slowed to 1-3 percent per year through 2009. One by-product of this deceleration in imaging growth was a weaker market for radiologists, who until recently could demand top salaries. The expansion of prior authorization, increased cost sharing, and other policies appear to have contributed to the slowdown. A meaningful fraction of the reduction in use involved imaging studies previously identified as having unproven medical value. What has occurred in the imaging field suggests incentive-based cost control measures can be a useful complement to comparative effectiveness research when a procedure's ultimate clinical benefit is uncertain.
MeSH term(s)	Comparative Effectiveness Research ; Diagnostic Imaging/trends ; Diagnostic Imaging/utilization ; Economic Recession ; Health Policy ; Humans ; Insurance Claim Review ; Insurance, Health/statistics & numerical data ; Insurance, Health, Reimbursement/trends ; Magnetic Resonance Imaging/utilization ; Medicare/statistics & numerical data ; Qualitative Research ; Tomography, X-Ray Computed/utilization ; United States
Language	English
Publishing date	2012-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632712-6
ISSN	1544-5208 ; 0278-2715
ISSN (online)	1544-5208
ISSN	0278-2715
DOI	10.1377/hlthaff.2011.1034
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