Reimbursement Challenges in Radiology: an Interview with Richard Heller, MD
In a recent interview at the annual RSNA conference in Chicago, Richard Heller, MD discussed the impact of reduced reimbursement rates in radiology, the projected CMS conversion factor for 2024, the severity of payment cuts in interventional radiology and the importance of radiologist advocacy.
Despite significant demand for radiologist services, Richard Heller, MD, noted that declining radiology reimbursement amid a backdrop of significant workforce shortages have created a “perfect storm” of stress for radiologists.
“We’ve got this demand coupled with a capacity limitation but at the same time we’re facing that, we’re also facing downward pressure on our reimbursement both from public payers like Medicare and commercial health-care payers,” explained Dr. Heller, the associate chief medical officer for Health Policy and Communications with Radiology Partners, during a recent interview at the annual RSNA conference in Chicago. “We’re doing all of this at a time of inflation. … At the same time you’re feeling overwhelmed with the (imaging) volume and demand, you’re getting paid less for that work.”
Based on 2024 projections of the conversion factor set by the Centers for Medicare and Medicaid Services (CMS) for Medicare reimbursement, declining radiologist reimbursement may become significantly worse.
“CMS has finalized a conversion factor for 2024 that would be lower than the conversion factor they used in 1994,” emphasized Dr. Heller. “To be clear, I’m not talking about inflation. The actual dollar value that CMS intends to pay doctors with in 2024 is lower than it was 30 years earlier in 1994.”
(Editor’s note: For related content, see “Stabilizing Medicare Reimbursement: a Plan for Action,” “Outpatient Reimbursement to Increase 65 Percent for EchoGo Heart Failure Platform in 2024” and “CMS Issues New Reimbursement Code for PSMA PET Agent POSLUMA.”)
Dr. Heller added that interventional radiology is projected to take the biggest CMS reimbursement cuts of any specialty in 2024.
“You’re disincentivizing investments in and disadvantaging a specialty, which I think we would all agree is minimally invasive and cost-effective,” maintained Dr. Heller. “It’s counterintuitive to disadvantage a specialty like interventional radiology, which actually improves the value of health care delivery.”
For more insights from Dr. Heller, watch the video below.
New Analysis Forecasts Substantial Cost Savings with the Use of Photon Counting CT for CCTA
March 8th 2025The use of ultra-high-resolution photon-counting CT in the evaluation of stable chest pain may significantly reduce follow-up tests and invasive coronary angiography (ICA) procedures, possibly resulting in millions in health-care cost savings, according to a cost-effectiveness analysis presented recently at the European Congress of Radiology.
The Reading Room: Artificial Intelligence: What RSNA 2020 Offered, and What 2021 Could Bring
December 5th 2020Nina Kottler, M.D., chief medical officer of AI at Radiology Partners, discusses, during RSNA 2020, what new developments the annual meeting provided about these technologies, sessions to access, and what to expect in the coming year.
Can Deep Learning Ultra-Fast bpMRI Have an Impact in Prostate Cancer Imaging?
March 3rd 2025A deep learning-enhanced ultra-fast bpMRI protocol offered similar sensitivity for csPCa as mpMRI with an 80 percent reduction in scan time, according to research findings presented at the European Congress of Radiology (ECR) conference.
RSNA 2020: Addressing Healthcare Disparities and Access to Care
December 4th 2020Rich Heller, M.D., with Radiology Partners, and Lucy Spalluto, M.D., with Vanderbilt University School of Medicine, discuss the highlights of their RSNA 2020 session on health disparities, focusing on the underlying factors and challenges radiologists face to providing greater access to care.
