Cardiovascular imaging payment and reimbursement systems: understanding the past and present in order to guide the future

Victor A Ferrari; Brian Whitman; James C Blankenship; Matthew J Budoff; Marco Costa; Neil J Weissman; Manuel D Cerqueira; ACC Imaging Council

doi:10.1016/j.jcmg.2014.01.008

Cardiovascular imaging payment and reimbursement systems: understanding the past and present in order to guide the future

JACC Cardiovasc Imaging. 2014 Mar;7(3):324-32. doi: 10.1016/j.jcmg.2014.01.008.

Authors

Victor A Ferrari¹, Brian Whitman², James C Blankenship³, Matthew J Budoff⁴, Marco Costa⁵, Neil J Weissman⁶, Manuel D Cerqueira⁷; ACC Imaging Council

Affiliations

¹ Department of Medicine (Cardiovascular Medicine) and Penn Cardiovascular Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: ferrariv@mail.med.upenn.edu.
² American College of Cardiology, Washington, DC.
³ Department of Cardiology, Geisinger Medical Center, Danville, Pennsylvania.
⁴ David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California.
⁵ Division of Cardiology, University Hospitals Case Medical Center, Case Western Reserve School of Medicine, Cleveland, Ohio.
⁶ MedStar Health Research Institute and Georgetown University, Washington, DC.
⁷ Imaging and Heart and Vascular Institutes, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.

PMID: 24651111
DOI: 10.1016/j.jcmg.2014.01.008

Abstract

Uncertainty regarding the future of cardiovascular (CV) services and reimbursement systems in this era of rapid change in health care delivery may lead to further confusion among imagers. This article provides a brief history of national payment and reimbursement systems, and discusses potential changes that will impact CV imaging in the coming years. Data over the last decade are presented on payment and utilization of services to demonstrate the impact of reimbursement reforms and education on imaging use.

MeSH terms

Cardiovascular Diseases / diagnosis*
Cardiovascular Diseases / economics*
Diagnostic Imaging / economics*
Diagnostic Imaging / methods
Forecasting
Health Care Costs* / legislation & jurisprudence
Health Care Costs* / trends
Health Policy / economics
Humans
Insurance, Health, Reimbursement* / legislation & jurisprudence
Insurance, Health, Reimbursement* / trends
Medicare / economics
Policy Making
Predictive Value of Tests
United States