HEALTH SERVICES RESEARCH
Identifying the value of neurologists is one of the pivotal components of the AAN's vision of being indispensable to its members. While this charge is broad, one of the most direct mechanisms of evaluating the value of neurologists is health services research. The Health Services Research (HSR) Subcommittee of the American Academy of Neurology (AAN) was established in April 2017 as a subcommittee of the Medical Economics and Management (MEM) Committee. HSR is a natural extension of the MEM Committee, which champions the quality practice of neurology by improving the economic and regulatory environment for members through education and advocacy. In order to effectively understand and improve the regulatory environment, the HSR Subcommittee provides quantitative and qualitative evidence on the value of neurologists.
MISSION OF THE HEALTH SERVICES RESEARCH SUBCOMMITTEE
The current charge of the HSR Subcommittee is to identify effective and efficient health care delivery models involving neurologists by:
- Evaluating the impact of neurologists on the care of patients (i.e. value of neurologists)
- Evaluating the impact of Medicare on neurologists (i.e. policy evaluations)
- Creating a national focus and community for health services research (HSR) in neurology
The HSR Subcommittee uses both public and private data in its research and has produced multiple publications in recent years. The Medical Expenditure Panel Survey (MEPS) data files and the various public use Medicare files are the most common source of public data that the HSR Subcommittee uses. When using proprietary datasets, the HSR Subcommittee leverages group members who have access to large, private claims databases.
HELPFUL LINKS
- Massachusetts General Hospital Neuro Value Lab
- UCLA Health Services Research
- Veterans Affairs HSR and Development
- University of Michigan Health Services Research Program
VALUE OF NEUROLOGY BIBLIOGRAPHY BY CONDITION
General Neurology
Callaghan BC, Reynolds E, Banerjee M, Kerber KA, Skolarus LE, Magliocco B, Esper GJ, Burke JF. Out-of-pocket costs are on the rise for commonly prescribed neurologic medications. Neurology 2019 May; 92 (22): e2604-e2613.
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de Havenon A, Delic A, Dehoney S, Whetman P, Sheibani N, Callaghan B, Ney J, Esper GJ, Magliocco B, Nair KV. Five-Year Trends in Payments for Neurologist-Prescribed Drugs in Medicare Part D. Neurology. 2021 Apr; 96 (16): e2132-e2137.
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Yu MM, Merillat SA, Weathers AL, Evans DA, Wolf FA, Ney JP. Gender Discrepancies in Neurologist Compensation. Neurology. 2022 Mar; 98 (9): e893-e902.
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Reynolds EA, Gallagher G, Hill CE, Banerjee M, Mante A, Esper GJ, Callaghan BC. Costs and Utilization of New-to-Market Neurologic Medications. Neurology. 2023 Feb; 100 (9): e884-e898.
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Burke JF, Skolarus LE, Callaghan BC, Kerber, KA. Choosing Wisely: Highest-cost tests in outpatient neurology. Annals of Neurology. 2013 May;73(5):679-83.
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Callaghan BC, Burke JF, Feldman EL. How neurologists can choose (even more) wisely: prioritizing waste reduction targets and identifying gaps in knowledge. JAMA. 2014 Apr 23-30;311(16):1607-8.
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Skolarus LE, Burke JF, Callaghan BC, Becker A, Kerber KA. Medicare payments to the neurology workforce in 2012. Neurology. 2015 Apr 28;84(17):1796-802.
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Callaghan BC, De Lott LB, Kerber KA, Burke JF, Skolarus LE. Neurology Choosing Wisely recommendations: 74 and growing. Neurology Clinical Practice. 2015 Oct; 5(5): 439–447.
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Ney JP, Johnson B, Knabel T, Craft K, Kaufman J. Neurologist ambulatory care, health care utilization, and costs in a large commercial dataset. Neurology. 2016 Jan 26; 86(4): 367-74.
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De Lott LB, Burke JF, Kerber KA, Skolarus LE, Callaghan BC. Medicare Part D payments for neurologist prescribed drugs. Neurology. Apr 2016; 86(16): 1491-1498.
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Callaghan BC, Burke JF, Skolarus LE, Jacobson RD, De Lott LB, Kerber KA. Medicare's Reimbursement Reduction for Nerve Conduction Studies: Effect on Use and Payments. JAMA Internal Medicine. 2016 May 1; 176(5): 697–699.
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Burke JF, Kerr EA, McCammon RJ, Holleman R, Langa KM, Callaghan BC. Neuroimaging overuse is more common in Medicare compared with the VA. Neurology. Aug 2016; 87(8): 792-798.
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Headache
Callaghan BC, Kerber KA, Pace RJ, Skolarus LE, Burke JF. Headaches and neuroimaging: High utilization and costs despite guidelines. JAMA Internal Medicine. 2014 May;174(5):819-21.
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Callaghan BC, Kerber KA, Pace RJ, Skolarus LE, Cooper W, Burke JF. Headache neuroimaging: Routine testing when guidelines recommend against them. Cephalalgia. 2015 Nov;35(13):1144-52.
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Callaghan BC, Burke JF, Kerber KA, Skolarus LE, Ney JP, Magliocco B, Esper GJ. The association of neurologists with headache health care utilization and costs. Neurology. Feb 2018; 90(6): e525-e533.
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Ney JP, Sico JS, Klein BC, Magliocco B, Callaghan BC, Esper GJ. Association of neurologist care with headache expenditures: A population-based, longitudinal analysis. Cephalalgia. March 4, 2018; 0(0): 1-9.
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Parkinson’s Disease
Reynolds EL, Burke JF, Banerjee M, Kerber KA, Skolarus LE, Magliocco B, Esper GJ, Callaghan BC. Association of out-of-pocket costs on adherence to common neurologic medications. Neurology. 2020 Mar: 94 (13): e1415-e1426.
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Willis AW, Schootman M, Tran R, Kung N, Evanoff BA, Perlmutter JS, Racette BA. Neurologist-associated reduction in PD-related hospitalizations and health care expenditures. Neurology. Oct 2012; 79 (17): 1774-1780.
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Dahodwala N, Willis AW, Li P, Doshi JA. Prevalence and correlates of anti-Parkinson drug in nationally representative sample. Movement Disorders Clinical Practice. June 2017.
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Fullard ME, Thibault DP, Hill A, Fox J, Bhatti DE, Burack MA, Dahodwala N, Haberfield E, Kern D, Klepitskava OS, Urrea-Menodza E, Myers P, Nutt J, Rafferty M, Schwalb JM, Shulman LM, Willis AW. Utilization of rehabilitation therapy services in Parkinson disease in the United States. Neurology. Sep 2017; 89 (11): 1162-1169.
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Neuropathy
Callaghan BC, Kerber KA, Smith AL, Fendrick M, Feldman EL. The evaluation of distal symmetric polyneuropathy: a physician survey of clinical practice. JAMA Neurology. 2012; 69(3):339–345.
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Callaghan BC, McCammon R, Kerber KA, Xu X, Langa KM, Feldman EL. Tests and expenditures in the initial evaluation of peripheral neuropathy. JAMA Internal Medicine. 2012 Jan 23; 172(2): 127–132.
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Callaghan BC, Burke JF, Rodgers A, McCammon R, Langa KM, Feldman EL, Kerber, KA. Expenditures in the elderly with peripheral neuropathy: Where should we focus cost-control efforts? Neurology Clinical Practice. 2013 Oct;3(5):421-430.
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Callaghan BC, Kerber KA, Lisabeth LL, Morgenstern LB, Longoria R, Rodgers A, Longwell P, Feldman EL. Role of neurologists and diagnostic tests on the management of distal symmetric polyneuropathy. JAMA Neurology. 2014 Sep;71(9):1143-9.
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Callaghan BC, Kerber KA, Banerjee M, Feldman EL, Morgenstern LB, Longoria R, Rodgers A, Longwell P, Lisabeth LD. The evaluation of distal symmetric polyneuropathy: utilization and expenditures by community neurologists. Journal of Neurology, Neurosurgery, and Psychiatry. 2016 Jan; 87(1):113-4.
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Epilepsy
Hill CE, Lin CC, Burke JF, Kerber KA, Skolarus LE, Esper GJ, Magliocco B, Callaghan BC. Claims data analyses unable to properly characterize the value of neurologists in epilepsy care. Neurology. 2019 Feb; 92 (9): e973-e987.
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Moura LMVR, Magliocco B, Ney JP, Cheng EM, Esper GJ, Hoch DB. Implementation of quality measures and patient-reported outcomes in an epilepsy clinic. Neurology. 2019 Nov: 93 (22): e2032-e2041.
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Please contact Ellen Anderson-benge if you have any questions regarding Health Services Research at the AAN.