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.

Alison Bailey, MD, FACC, chief of cardiology, Centennial Heart at Parkridge Medical Center, and a physician director of cardiovascular disease for HCA Healthcare. She was the co-chair of a four-part series on the business of cardiology sessions at ACC 2024. She explains why ACC chose to concentrate on business. #ACC #ACC24 #ACC2024 #Cardiologybusiness

Why the business side of cardiology was a key focus at ACC.24

Alison Bailey, MD, co-chair of the business of cardiology sessions at ACC.24, emphasized that reimbursement cuts can have a long-term negative impact on patient. 

April 24, 2024
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Cardiologist salary update: Compensation jumps to $525K per year, No. 3 among all specialties

In addition, cardiologists average an additional $75,000 per year in incentive-based bonuses. That number is only higher for two other specialties. 

April 15, 2024
Medicare money payment physician. The CardioVascular Coalition and Society for Cardiovascular Angiography and Interventions have both issued new statements highlighting their issues with the 2024 MPFS proposed rule. 

Critics call out ‘woefully inadequate’ CMS proposal for inpatient Medicare payments

CMS has issued its proposed rule for the 2025 Medicare hospital inpatient prospective payment system, suggesting a payment increase of 2.6%. According to the American Hospital Association, this update would not be enough at a time when hospitals are already struggling to stay open. 

April 11, 2024
Video - Ken Rosenfield, MD, MGH, and William Gray, MD, Lankenau Heart, explain impact of new CMS coverage for carotid stenting.

How a big CMS update on carotid stenting could impact interventional cardiology

Ken Rosenfield, MD, of Massachusetts General Hospital, and William Gray, MD, of Lankenau Heart Institute, detailed the long-term impact of a key policy shift. 

March 5, 2024
Carrie Redick RN MSN NEA-BC, director of interventional cardiology and structural heart, Morristown Medical Center, Atlantic Health System, explains the need for financial literacy among structural heart program directors at the Transcatheter Cardiovascular therapeutics (TCT) 2023 meeting.

Why financial literacy is so important for structural heart program directors

Carrie Redick, an ICU nurse for nearly 20 years, said understanding more about financial data improved her ability to acquire funding and other resources for her program when necessary. 

February 27, 2024
American Society of Nuclear Cardiology (ASNC) 2024 President Lawrence Phillips, MD, FASNC, director of nuclear cardiology and medical director for outpatient cardiology at NYU Langone Health, explains ASNC’s advocacy efforts for Medicare payments and reform.

ASNC president advocates for Medicare reimbursement reform

Lawrence Phillips, MD, president of the American Society of Nuclear Cardiology, said that U.S. physicians are growing more and more frustrated by Medicare policies.

February 9, 2024
Medicare money payment reimbursement dollar decline. More than 100 U.S. medical societies are throwing their support behind a new proposal that could reform out-of-date Medicare policies and help limit future payment cuts. 

Cardiologists speak out about reimbursement cuts, say Congress ‘left clinicians holding the bag’

When Congress passed its latest continuing resolution to avoid a government shutdown, it provided no relief for cardiologists and other physicians impacted by ongoing Medicare reimbursement cuts. The American College of Cardiology responded to this development with yet another plea for change. 

January 22, 2024
Richard Heller, MD, RSNA Board member, associate chief medical officer for health policy and communications, and national director of pediatric radiology at Radiology Partners, explains some insurance companies are trying to take advantage of the No Surprises Billing Act by telling radiology practices they need to accept lower rates to remain part of the providers in-network.

Radiologists urged to report insurance companies forcing lower reimbursements due to No Surprises Act

Some payers are taking advantage of the NSA by forcing practices to accept lower rates to remain in-network, says Rad Partners' Richard Heller, MD. 

January 18, 2024

Around the web

Five of the largest U.S. medical societies focused on cardiovascular health are one step closer to seeing their paradigm-shifting proposal become a reality.

The Society for Cardiovascular Angiography & Interventions and Society of Thoracic Surgeons have both shared statements in support of the ban, which is already being challenged in court. The American Hospital Association, meanwhile, opposes the policy shift, saying it “errs by seeking to create a one-size-fits-all rule”

Alison Bailey, MD, co-chair of the business of cardiology sessions at ACC.24, emphasized that reimbursement cuts can have a long-term negative impact on patient. 

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