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.

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physician tracking patient data and reporting on outcomes

Q&A: Cardiologist Karen Joynt Maddox on why new healthcare policies are not improving outcomes

Healthcare's ongoing shift toward value-based care is a good thing, Joynt Maddox explained, but its implementation has been far from ideal. She also discussed population health, the pandemic, health disparities and the rising influence of private equity investments.

Drawing inspiration from the World War II “Why We Fight” campaign that rallied support for the U.S. war effort, American Medical Association (AMA) President Jesse M. Ehrenfeld, MD, MPH, drew comparisons with the uphill battles physicians are facing today with dwindling reimbursements, physicians shortages, burnout and administrative fights against prior authorization burdens and attempts to preserve access to telehealth. #AMA #AMAHOD24 #AMAHOD2024 #HOD #HOD24 #HOD2024

AMA president calls for physicians to take war-time footing in fight over reimbursement, care quality

Drawing inspiration from the World War II “Why We Fight” campaign that rallied support for the U.S. war effort, AMA President Jesse  Ehrenfeld, MD, spoke on the uphill battles physicians are facing today.

How cardiologists and hospitals get paid via RVUs and DRGs There has been an increasing number of "business of cardiology" sessions are several cardiology conferences over the past two year as reimbursements continue to decline and costs continue to increase. Chief among the topics discussed has been how to navigate the intricacies of how cardiologists and hospitals are reimbursed. One of these speakers was Joel Sauer, MBA, executive vice president of consulting, MedAxiom, who spoke at the American Colle

How cardiologists and hospitals get paid

Joel Sauer, MBA, executive vice president of consulting with MedAxiom, reviews the intricacies of how cardiologists and hospitals are reimbursed.

HeartFlow Plaque Analysis

AI-based coronary plaque assessments 1 step closer to Medicare coverage

According to a new proposal, using AI to evaluate CCTA results and quantify plaque buildup is “reasonable and medically necessary” in certain clinical scenarios.

U.S. News & World Report children’s hospitals cardiology heart surgery

New one-stop cardiology clinic focuses on patient relationships, not insurance

A cardiologist in Billings, Montana, says her new-look practice was designed to reach patients faster and ditch unnecessary red tape. Patients pay an upfront fee, and insurance does not play a role in treatment decisions.

AMA chart showing Medicare update payments compared to the cost of practice inflation between 2001-2024. The ongoing AMA PPI survey will be used top recalculate radiology practice expenses, but only 10 practices so far has submitted data that will impact all radiology practices.

Only 10 radiology practices completed survey used to adjust Medicare payments

The ACR shared its concerns about the lack of participation as the deadline approaches. 

lex Sandhu, MD, MS, assistant professor of cardiovascular medicine, Stanford University, and cardiologist at the Palo Alto VA. He spoke in the business of cardiology sessions at ACC 2024 and explained how Medicare reimbursements will be moving toward a value based payment model by 2030. #ACC #ACC24 #ACC2024 #CMS #reimbersements #Medicare

How the shift to value-based reimbursements could transform cardiology

"I think we really need our cardiologist community to understand the changes that are happening with value-based payment," one expert tells Cardiovascular Business. 

doctor's open hand waiting for a payment

‘Concerning’ data connect industry payments to cardiologists with medical device use

U.S. physicians often receive payments from medical device manufacturers and pharmaceutical companies. New research in JAMA found a connection between receiving such payments and using specific devices—should the industry be concerned? 

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