title: Nonresearch Industry Payments to Radiologists: Characteristics and Associations With Regional Medical Imaging Utilization.
abstract: OBJECTIVE
  To evaluate characteristics of nonresearch industry payments to radiologists and associations with regional diagnostic imaging utilization.
  
  
  METHODS
  Using 2014 CMS Open Payment data, all disclosed nonresearch-related industry payments to radiologists were identified. Health Resources and Services Administration Area Health Resources Files were used to identify actual and population-weighted numbers of radiologists by state. Utilizing the 5% random beneficiary sample CMS Research Identifiable Files from 2014, average Medicare imaging spending per beneficiary in each state was calculated. Average frequency and dollar amounts of nonresearch nonroyalty payments to radiologists were calculated at the state level. Using the Pearson correlation coefficient, the relationship between frequency and amounts of nonresearch payments to radiologists versus per-beneficiary Medicare imaging spending was evaluated at the state level.
  
  
  RESULTS
  Overall, 2,008 radiologists (1,670 diagnostic, 338 interventional) received nonresearch nonroyalty payments from industry, representing 5.2% of all 38,857 radiologists nationwide. A total of 4,975 individual transfers translated to 2.5 ± 1.3 discrete payments per receiving radiologist with a mean of $432 ± $1,976 (median $26; range $1-$34,050). Food and beverage expenses constituted the vast majority of disclosed transfers (4,111; 83%), followed by travel and lodging (444; 9%), consulting fees (279; 6%), and educational expenses (51; 1%). Considerable geographic variation in payments was observed, ranging from 0% of radiologists in Vermont to 12.9% in the District of Columbia. No correlation was identified between average per-beneficiary Medicare imaging spending and the proportion of nonresearch-funded radiologists in each state (r = 0.06). Similarly, no correlation was identified between average per-beneficiary Medicare imaging spending and the average nonresearch transfer amount to radiologists in each state (r = -0.08).
  
  
  CONCLUSIONS
  In 2014, only a small minority of United States radiologists received nonresearch payments from industry. At the state level, medical imaging utilization does not seem to be influenced by such financial relationships.
authors.affiliation: Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut. Electronic address: nima.kokabi@yale.edu.
authors.forename: Nima
authors.initials: N
authors.lastname: Kokabi
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Jacqueline C
authors.initials: JC
authors.lastname: Junn
authors.affiliation: Johns Hopkins School of Public Health, Baltimore, Maryland.
authors.forename: Minzhi
authors.initials: M
authors.lastname: Xing
authors.affiliation: Harvey L. Neiman Health Policy Institute, Reston, Virginia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hemingway
authors.affiliation: Harvey L. Neiman Health Policy Institute, Reston, Virginia; Department of Health Administration and Policy, George Mason University, Fairfax, Virginia.
authors.forename: Danny R
authors.initials: DR
authors.lastname: Hughes
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Richard
authors.initials: R
authors.lastname: Duszak
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D016265:Conflict of Interest; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D030881:Disclosure; D006801:Humans; D007221:Industry / Q000191:economics*; D006278:Medicare / Q000191:economics; D010818:Practice Patterns, Physicians' / Q000191:economics*; D000072177:Radiologists / Q000191:economics*; D014481:United States
keywords: Medicare imaging expenditure; Open payment database; Sunshine Act