Claim-Based Method for IR Identification

A Claims-Based Method for Identification and Characterization of Practicing Interventional Radiologists

Clinical question

How to identify practicing interventional radiologists when most of them are listed as diagnostic radiologists on national claims data sets?

Take away point

A claims-based method, using percent IR-related work effort, may provide generalizability and comparability for identifying practicing interventional radiologists.

Reference

Waid, M.D., Rula, E.Y., Hawkins, C.M., Findeiss, L. and Liu, R., 2024. A Claims-Based Method for Identification and Characterization of Practicing Interventional Radiologists. Journal of Vascular and Interventional Radiology, 35(6), pp.909-917.

Click here for abstract

Study design

Healthcare policy and economics study

Funding Source

Society of Interventional Radiology (SIR), Workforce Research Division

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Summary

The article discusses the challenges and proposed solutions for accurately identifying practicing interventional radiologists (IRs) using claims data. Despite many diagnostic radiologists (DRs) performing IR work, self-designated specialties often underrepresent the IR field, necessitating a reliable method to define and identify IRs for research purposes. The study found that a significant majority (around 80%) of IRs were listed as self-designated diagnostic radiologists in both Medicare and private insurance data. As the proportion of work devoted to IR-related services increased, more effort was allocated to surgical, invasive, and evaluation and management services, with less focus on noninvasive imaging.

The research aimed to develop and test an operational definition for identifying IRs based on claims data, using data from Medicare and commercial insurance claims. A major finding was that self-designated interventional radiologists comprised only a minority of those identified as practicing IRs at various work effort thresholds. The study demonstrated that as the percentage of IR-related work increased, the proportion of procedural and evaluation/management services rose, while noninvasive imaging efforts declined. This pattern was consistent across both Medicare and private insurance data.

Demographically, practicing IRs were more likely to be male, work in metropolitan areas, have fewer years since graduation, and be in smaller practice groups. The study proposed a methodology to improve the identification of IRs in claims data, which is important for advancing IR-related health services research. The authors emphasize that their approach aims to create consistent and replicable samples of IRs for research, rather than making judgments on specialty designations. This methodology is expected to facilitate better comparisons and conclusions in future IR-related studies.

Commentary

The demographic insights provided by the study, such as the higher likelihood of IRs being male, working in metropolitan areas, and being relatively early in their careers, offer valuable context for workforce planning and policy development. Additionally, the finding that IRs tend to work in smaller practice groups could inform strategic decisions in practice management and resource allocation.

But the most interesting finding in the article is the discrepancy between self-designated IRs and those identified through claims data, highlighting an underrepresentation of IR in national claims data. This underscores the potential significance of claims-based identification to capture the full IR workforce. The methodology's ability to discern IRs by analyzing the proportion of work devoted to IR-related services versus noninvasive imaging is a good framework that can enhance the accuracy of IR specialty identification.