The COVID-19 pandemic has quickly spread across all 50 United States. Associated recommendations that healthcare facilities defer non-urgent visits, tests, and procedures led many imaging facilities to temporarily substantially curtail most of their nonurgent services. This new Harvey L. Neiman Health Policy Institute study, published online in the Journal of the American College of Radiology, aimed to characterize the recent declines in noninvasive diagnostic imaging volumes at community practices.

“No community practice or geographically broader reports have yet emerged, nor have reports emerged that have considered the professional work relative value unit (wRVU) magnitude of these declines,” says lead author Richard Duszak, MD, FACR, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University and senior affiliate research fellow at the Neiman Institute. “Better knowledge about wRVU weighted declines focusing on sites of service, as well as modalities and body regions, could inform ongoing radiologist and technologist manpower, clinical coverage, and financial planning, as well as Medicare payment methodology.”

The researchers used aggregate imaging data from nine community radiology practices across the United States between January 2019 and May 2020, and mapped wRVUs to reported volumes of noninvasive diagnostic imaging services to calculate the total wRVU of services performed. Weekly 2020 versus 2019 wRVU changes were analyzed by modality, body region, and site of service.

Aggregate weekly wRVUs ranged from a high of 120,450 (during February 2020) to a low of 55,188 (during April 2020). During that -52% wRVU nadir, outpatient declines of 66% were greatest. As a percentage of total all-practice wRVUs, 31% declines in CT and 30% radiography/fluoroscopy were greatest. By body region, 25% declines in abdomen/pelvis and 19% breast imaging were greatest. Mammography and abdominal/pelvic CT accounted for the largest shares of total all-practice wRVU reductions.

“Substantial COVID-19 related diagnostic imaging work declines were similar across the community practices and disproportionately impacted mammography—which experienced a 92% decrease in wRVUs performed,” says coauthor Danny R. Hughes, executive director of the Neiman Institute and Georgia Tech professor of economics. “In light of predictions of an upcoming potentially disastrous ‘second wave’ of coronavirus disease, this information could prove actionable for radiology practice planning.”