In 2012, the ACR and the late Harvey L. Neiman, MD, FACR, made a bold move to impact the national health policy debate by forming a health policy organization now known as the Harvey L. Neiman Health Policy Institute^® (HPI). The HPI has played a crucial role in helping patients, practices, and policymakers make the best decisions possible to improve patient care.

To celebrate a decade of accomplishments and progress in 2022, the Bulletin has looked back at the highlights the HPI has provided these past 10 years. In this final installment of a three part series, the Bulletin delves into the HPI’s expertise, data, and portfolio of publications that have been an invaluable source of information, especially when it comes to the College’s strategic priorities. Read part one here and part two here.

Assembling World-Class Expertise

By building a well-rounded team, the HPI has been able to advance the College’s strategic plan with one goal in mind: improving patient care. “An important part of our strategy that has developed over the past couple of years has been to strengthen our core HPI staff’s research expertise and capabilities,” says Elizabeth Y. Rula, PhD, executive director of the HPI. “We brought in robust health economics expertise to complement the clinical expertise of the radiologists we collaborate with. We want to make sure we have the staff needed to remain responsive, providing ad hoc analytics and accelerated research to inform urgent topics. We also want to maintain our focus on future-looking work that includes robust studies published in peer-reviewed journals that address both pressing issues today and issues on the horizon.”

Rula says part of the HPI strategy was to “deepen the bench” when building an effective research team. The HPI needed a versatile staff that could address a range of questions and topics to ensure the Institute achieved its goals. “We hired highly experienced health economists, health services researchers, and an epidemiologist,” she says. “Having that expertise in-house allows us to study a range of topics simultaneously and broadly leverage the value within the data.”

Translating Evidence Into Action

Communicating research as relatable information to ACR members and staff is important to the HPI’s goal of having its research used as broadly as possible to advance the ACR strategy and policy that supports radiology practice advancement. The HPI uses multiple channels for this communication, including its website, press releases, e-newsletter, social media, annual reports, and the Bulletin.

“The HPI has worked hard to build visibility of its research for multiple audiences so that the wide array of our stakeholders can readily find, understand, and reference the research they
need for their initiatives,” Rula says. “A foundational aspect of all those different channels is the goal of translating the research into actionable information. That way our internal and external stakeholders know how to use what we have found to drive forward radiology and health policy.”

The HPI has worked hard to build visibility of its research for multiple audiences so that the wide array of our stakeholders can readily find, understand, and reference the research they need for their initiatives.

Partnering Up

Working together with the ACR’s many departments is crucial to the HPI’s success. “If our work doesn’t support the broader ACR strategy and the objectives of other teams, then we’ve missed opportunities for impact,” Rula says.

The ACR Economics team is a regular internal customer for HPI analytics. The team’s requests often involve analytics to determine the likely impact of changes in payment policy and the Medicare Physician Fee Schedule, from creating new bundled payment models to creating, revising, or retiring CPT^® codes. “We can rely on HPI staff to quickly respond when we need answers to bring to the RUC or CPT Editorial Panel, and to ensure that we have the data to help define and strengthen our coding position,” says Maria Tran, ACR director of economic policy.

This partnership can be seen in the HPI’s relationship with the ACR Department of Quality and Safety (Q&S), which has worked on a couple of projects with the HPI. Mythreyi B. Chatfield,
PhD, ACR’s executive vice president of Q&S, says, “We have found synergies where the HPI has collaborated with Q&S, leveraging their complementary data and skills in research design
and statistics.” She discussed one project where the National Mammography Database had physician data on quality measures and how a particular physician was performing, while the HPI had data on the physicians in terms of where they practiced and their overall practice volume.

“We were able to pull the two pieces together and identify physician characteristics associated with higher or lower quality in mammography,” Chatfield says.¹ The HPI team also performs specific data analytics to help identify opportunities for radiologists in Quality Payment Programs and current participation and success in these programs from Medicare data.

Government relations is another frequent collaborator. “What helps is that the HPI has data that can answer the wide range of imaging questions the federal government and state governments may have,” says Josh Cooper, ACR vice president of government relations and economic health policy. “That data is reliable and not only helps us make our case, but also helps lawmakers and other government officials demonstrate to their constituents the evidence behind their positions on issues such as surprise billing and Medicare reimbursement.”

Earlier this year, the No Surprises Act, aimed at helping prevent surprise billing, was a focus of the two departments. “The HPI has been very helpful as we monitor and navigate the implementation of the No Surprises Act,” Cooper says. “There have been concerns raised by the ACR and other medical specialty societies about the interpretation by insurers on how the Act should move forward. The HPI examined the data that has been produced to help these medical societies make their case and demonstrate to the federal government that our concerns about the insurance companies’
interpretations are valid. The HPI has been very instrumental in helping us crunch the data and make sure we’re on the right path with our concerns.”

The impact of these efforts can be seen in the ACR’s ongoing advocacy efforts, such as surprise billing, cancer screening, and other issues. “The HPI is crucial in providing data that makes it much harder for members of Congress and Capitol Hill staff to say no when it comes to issues of patient care and physician reimbursement,” Cooper says. “This evidence-driven approach sets us apart
from other physician groups in that we back up our positions with reliable data.”