Business Aspects of Cardiovascular Computed Tomography: Tackling the Challenges

A new business paradigm to make coronary CT angiography (CCTA) accessible to all

Recently, the Centers for Medicare and Medicaid proposed a classification change that, if enacted, could double reimbursement for coronary CT angiography (CCTA) in the U.S. [1]. With this comes the potential to realistically build an economically viable and sustainable model to deliver cardiac CT outside of major urban (hospital and private practice) and academic centers. The value of CCTA in reducing cardiovascular morbidity and mortality has been demonstrated in large, randomized control trials and real-world studies, but access to CCTA in rural, socially deprived, and low-resource settings (including poorer urban areas with a lack of specialist equipment and specialty-based services) remains a significant challenge. This paper discusses the end-to-end business aspects required to deliver a sustainable cardiac CT service in these areas, exploring technologist-delivered services, with remote support from physicians, and the potential to leverage developing artificial intelligence (AI) decision aid tools and mobile scanners.

Establishing a successful cardiovascular computed tomography service: Financial and regulatory challenges facing radiologists and cardiologists

Cardiac imagers, radiologists or cardiologists, do not receive adequate training or preparation for the harsh realities of running imaging programs and most of the training follows graduation where they are learning on the job and from their own mistakes. There are many factors and skill sets need to help imagers to run a successful and financially independent practice that are easily not easily acquired or researched independently. The intent of this review is to provide a checklist of steps recommended to create a successful program and to give insight into the financial considerations associated with workforce, equipment, training and sustainability. The challenges faced are broadly similar between practice types, but some distinct differences do exist within varying practice environments.

Cardiac CT angiography: Financial implications of different practice types

Cardiac computed tomography (CT) is an important diagnostic tool in the management of cardiovascular disease. Various factors influence the overall financial viability of a cardiac CT program, including hardware, software, personnel, billing, and practice type. This review offers a comprehensive analysis of these different cardiac CT costs, and how programs across various practice types manage them.