Revenue & Reimbursement

Healthcare reimbursement is payment that a hospital, diagnostic imaging facility, subspecialty department or healthcare providers receive for performing a service. This also includes individual radiologist or cardiologist reimbursement and billing and coding rules for submitting claims.

The integration of artificial intelligence (AI) into radiology PACS and enterprise imaging systems has become a big topic of discussion with IT vendors over the past couple years. This has become a bigger question from hospitals and radiology groups as there are now about 400 radiology related AI algorithms that have U.S. Food and Drug Administration (FDA) clearance. Amy Thompson, a senior analyst at Signify Research, is monitoring AI trends in radiology and discusses trends.

Trends in the adoption and integration of AI into radiology workflows

Amy Thompson, a senior analyst at Signify Research, explains why AI adoption has been slow in radiology, common barriers and trends in the market.

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Florida cardiology practice, 10 cardiologists pay $2M to settle fraud allegations

The practice and many of its cardiologists allegedly submitted false claims to Medicare, Medicaid, TRICARE and the Federal Employee Health Benefits Program. 

Cleveland Clinic CEO warns of $200M loss in 2022

Cleveland Clinic CEO and President Tom Mihaljevic, MD, gave the healthcare organization’s State of the Clinic speech on Jan. 18, sharing optimism for the company’s future despite a $200 million loss in 2022.

Clyde W. Yancy, MD, MSc, vice dean for diversity and inclusion, chief of cardiology in the Department of Medicine, and a professor of medicine in cardiology and medical social sciences at Northwestern Medicine, discusses health equity issues in cardiology at the American Heart Association (AHA) 2022 meeting.

VIDEO: Health equity and diversity is a business model

Clyde Yancy, MD, vice dean for diversity and inclusion, chief of cardiology, and a professor of medicine in cardiology and medical social sciences at Northwestern Medicine, discusses health equity issues and how greater inclusion should be a business model because of changing demographics.

Claire Ernst, director of government affairs, Medical Group Management Association (MGMA), explains the list of priorities for the association. These include staving off the large, planned 2023 Medicare reimbursement cuts, fighting for continuation of reimbursements for telehealth, and revamping prior authorizations.

VIDEO: Top priorities for the Medical Group Management Association in 2022

Claire Ernst, director of government affairs, Medical Group Management Association (MGMA), explains the list of priorities for the association, include staving off the large Medicare reimbursement cuts, continuation of telehealth reimbursements, and revamping prior authorizations. 

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Health spending reached $4.3 trillion in 2021

After a significant jump in healthcare spending in 2020 with the onset of the COVID-19 pandemic, healthcare spending in the United States only increased 2.7% in 2021, according to new analysis from the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS), published in Health Affairs.

VIDEO: Impact of the 2023 Medicare cuts on radiology

Ed Gaines, JD, vice president of regulatory affairs and industry liaison, Zotec Partners, discussed the impact of the 2023 Medicare Fee Schedule on radiology at RSNA 2022 in Chicago last week. RSNA and several other medical societies say the cuts are not sustainable.

Ed Gaines, JD, CCP, vice president of regulatory affairs and industry liaison, Zotec Partners, discusses the No Surprises Act on radiology at the Radiological Society of North America (RSNA) 2022 meeting. Gaines works with RSNA on billing and Medicare issues and spoke in sessions at the RSNA 2022 meeting. Insurance companies have weaponized the No Surprises Act in an effort to cut their costs, he said.

VIDEO: Insurance companies have weaponized the No Surprises Act, may impact patient care

Ed Gaines, JD, CCP, vice president of regulatory affairs and industry liaison, Zotec Partners, discusses the impact of the No Surprises Act on healthcare and medical imaging at the RSNA 2022 meeting