Gowda V et al, writing in JACR on the Biden Administration’s executive order on AI.

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Imaging Policy & Legislation

Doctors Work Harder for Less

Medicare reimbursement to physicians per beneficiary has declined over the last 16 years, with radiologists among the biggest losers. That’s according to a new study by the ACR’s Harvey L. Neiman Health Policy Institute, which confirms what many physicians already knew: they are working harder for less money.

It’s no secret that the US government has been struggling to rein in healthcare costs for decades. 

• As we’ve discussed previously, the US pays far more for healthcare as a share of GDP than other developed countries. 

CMS has a number of tools at its disposal for controlling Medicare and Medicaid costs, one of which is the relative value unit (RVU) scale. 

• RVUs – when multiplied by monetary conversion factors – basically set the amount of money the agency pays physicians per unit of work, with CMS typically reducing the conversion factor when it needs to cut Medicare spending. 

In the new study in the journal Inquiry, Neiman HPI researchers analyzed trends in RVU and conversion factor levels per Medicare beneficiary from 2005 to 2021, analyzing changes to calculate how much work providers have to do to deliver a unit of care. Findings included …

• Reimbursement per Medicare beneficiary after inflation adjustment fell 2.3% for physicians as a whole
• Radiology saw one of the biggest declines in MPFS reimbursement per beneficiary, ranking 31st on a list of 39 medical specialties, with a 25% decrease
• Reimbursement has risen 207% for non-physician practitioners

What’s driving the declines? The Neiman HPI researchers identified the federal government’s budget neutrality rules for Medicare, which stipulate that increases in one area have to be offset by declines elsewhere.

• Indeed, CMS has made no secret of the fact that it wants to shift more payments to primary care physicians, and that it’s willing to cut reimbursement to specialists to do so.  

The Takeaway

The new findings confirm what many physicians have suspected – they are not only working harder for less, but non-physician practitioners seem to be getting a bigger piece of the pie. Combined with a recent report showing that radiologist salaries didn’t keep pace with inflation in 2023, it’s not a pretty picture. 

Approaches to Deploying Clinical AI

Join this April 30 educational webinar hosted by Aidoc and Merge by Merative to learn about real-world approaches to deploying AI solutions. Don’t miss this chance to learn how AI can be integrated into your workflows and help transform patient care.

Demystifying Data Monetization in Healthcare

Some healthcare providers are reluctant to fully embrace data monetization. But done right, it can be a force for good. Learn how data monetization can enhance clinical decision-making, optimize workflows, and improve patient outcomes in this article from Enlitic.

The Wire

• Philips Warning Letter over CT Plant: Philips has received a warning letter from the FDA over manufacturing practices at a CT factory in China. The letter claims that an FDA inspection in October 2023 found the facility was not in compliance with current good manufacturing practices, particularly due to the company’s response to customer complaints about connection issues with a data cable it sourced from a third-party supplier. A Philips spokesperson told The Imaging Wire that the company is moving to address the FDA’s concerns, and noted that the agency’s observations did not involve any reports of patient harm. 

• Deconstructing Biden’s AI EO: What does the Biden Administration’s executive order on AI from October 2023 mean for medical imaging? Authors from MGH and Harvard offer an analysis in JACR, stating that while the AI EO offers “little immediate change” for radiology, it portends “significant regulatory shifts” coming up, including increased regulatory scrutiny of AI-based CAD software as well as disclosure to regulators of datasets used to train AI algorithms. The authors advise radiologists and AI developers to make adjustments in advance to comply with upcoming rules. 

• USPSTF Opens CAC Scoring Review: The USPSTF has opened a review of its recommendations on cardiovascular risk assessment with CT-based coronary artery calcium scoring, as well as ankle brachial index. The group’s most recent review – issued in 2018 – said CAC scoring had no benefit over traditional risk factors, but since then multiple studies have been published highlighting its prognostic power. The USPSTF is taking comments through May 22. 

• ScreenPoint Taps New CEO: Breast AI developer ScreenPoint Medical has tapped a new CEO. Pieter Kroese will be taking over the role from Mark Koeniguer, who is stepping down after two years at ScreenPoint’s helm. Kroese previously served as ScreenPoint’s COO for five years, managing the company’s transition from a startup to an established firm with hundreds of customers using its Transpara software. 

• AI Combo Predicts Cardiovascular Mortality: In a paper in Nature Communications, researchers combined their homegrown AI for CAC scoring with the TotalSegmentator open-source segmentation software to predict cardiovascular mortality from chest CT scans. In 24k patients from the NLST trial, the combo had AUC of 0.69 for all-cause mortality and 0.77 for cardiovascular mortality; similar results were found with two other patient groups. The combined approach could give clinicians an automated tool for identifying cardiovascular risk by analyzing chest CT scans acquired for non-cardiac purposes.

• HAP Lands NH Practice: Healthcare Administrative Partners will be rocking radiology revenue cycle management in the Granite State thanks to a new partnership with Atlantic Radiology New Hampshire in Portsmouth. HAP will perform all core revenue cycle services under the deal, including billing, coding, carrier credentialing, business intelligence, and MIPS measure assurance services. The deal adds to HAP’s growing momentum in the northeastern US, including contracts in New Jersey and New England.

• CT-Like MRI for Fractures: German researchers found that CT-like images with a 3T MRI scanner worked well for detecting hand and wrist fractures. In Skeletal Radiology, they tested a 3D T1GRE sequence in scans of 28 patients and 43 controls with Siemens Healthineers’ Magnetom Prisma scanner; two readers found no statistically significant difference in image quality and diagnostic confidence. Sensitivity, specificity, and accuracy ranged from 0.92 to 1.0, leading researchers to conclude CT-like MRI is suitable for hand and wrist fractures – without CT’s radiation dose.

• IVUS Beats Angiography Again: A new Lancet study added to intravascular ultrasound’s growing advantage over angiography. Analysis of 3.5k randomized patients showed that IVUS guidance led to a one-year target vessel failure rate of 4%, well below angiography’s 7.3% failure rate. This decrease was primarily due to fewer incidences of target vessel MI and revascularization, with no notable variations observed in all-cause death or stent thrombosis.

• Cortechs Updates Neuro Software: Cortechs.ai has updated its flagship NeuroQuant software. Version 5.0 of the application now supports identification and evaluation of cerebral microhemorrhages on susceptibility-sensitive MRI sequences. The new version will prove useful for identifying small focal brain lesions commonly found in patients with conditions ranging from TBI to Alzheimer’s disease. FDA clearance for v5.0 is pending.

• Are Payors Too Big to Fail? A beautiful chart was making the rounds last week after Axios crunched the numbers on the six largest payors’ revenue as a share of total US health spending, which now stands at an impressive 30%. The size of these companies raises some big questions about whether payors being “too big to fail” is healthy for the industry, while also highlighting how quickly their scope is expanding. Of the top six payors, three processed nearly 80% of last year’s prescriptions, one is owned by the nation’s largest pharmacy chain, and one is the nation’s largest employer of physicians.

• NewVue’s Reseller Deal: NewVue has signed on a reseller for its cloud-based radiology workflow software, inking a deal with Electromek Diagnostic Systems. Electromek gains US rights to sell NewVue’s EmpowerSuite, which is designed to serve as a radiologist cockpit, eliminating the need for multiple worklists and reducing administrative burdens. NewVue launched in 2023 by executives formerly with PeerVue.

• Smart Reporting Raises €23M: German medical reporting software developer Smart Reporting has raised €23M euros ($24.6M), which it plans to use to fund product development as well as aid its expansion into new international markets, including the US, Canada, Australia, and New Zealand. The company’s solutions focus on radiology and pathology reporting, with its SmartReports application distributed internationally through partnerships with OEMs including Siemens Healthineers and GE HealthCare; it also has a partnership with Solventum. Smart Reporting raised €15M in 2020.

AI and Matters of the Heart

As clinicians face increasing pressure from all sides, can AI provide some much-needed breathing space? In this article from Blackford, learn more about how AI is assisting with cardiac imaging with modalities ranging from CT to echocardiography.

Keep Patients Engaged with Your Healthcare System

After using PocketHealth, 94% of patients are more confident about their healthcare experience. Learn how to increase follow-up adherence, improve communication, and provide screening tools to keep your patients on track with PocketHealth’s MyCare Navigator.

Making Advanced Cardiac CT Accessible Everywhere

How do you bring cardiac CT to high-risk patients in rural areas? Watch this video from Siemens Healthineers to learn insights into setting up a cardiovascular CT program in a rural area – and how to overcome associated challenges.

The Resource Wire

• Cloud-Based Disaster Recovery: When disaster strikes, have peace of mind knowing your imaging data is safe. Securely store backups with Intelerad’s Cloud DR solution, ensuring business continuity when it counts the most. Get started by booking a demo today. 

• Growing Your Practice When It’s Impossible to Recruit and Retain: How can radiology practices address the pressing need for multi-specialized radiologists? In this fireside chat, Medality CEO and Co-Founder Daniel Arnold talks to Dr. Catherine Jones of I-MED Radiology about the challenge. 

• Allina Turns to the Cloud for Better Patient Care: Allina Health needed to replace its on-premises PACS to better serve patients. Learn how Allina turned to Amazon Web Services (AWS) and Visage Imaging for a cloud-based implementation of the Visage 7 enterprise imaging platform. 

• Best in KLAS for Image Exchange: With over 15k connected facilities and a dedicated outreach team building new connections every day, it’s no wonder Nuance PowerShare Image Sharing was named #1 Best in KLAS 2024 for image exchange. Learn more about this award-winning solution. 

• Echo AI for HFpEF Evaluation: Learn more about new research using Us2.ai compared to gold-standard invasive hemodynamic measurement showing that in patients with HFpEF, echo AI measurements are interchangeable with manual core-lab measures to diagnose increased filling pressures and may result in more frequent recognition of HFpEF. 

• Optimizing Emergency Department Efficiency with AI: Emergency departments around the world are facing challenging conditions. Find out how CHU Rennes in France successfully integrated BoneView from Gleamer for AI-powered fracture detection. 

• Presenting Unboxing AI: Check out CARPL’s brand-new video series, Unboxing AI, featuring experts discussing AI and its future in radiology. The inaugural episode includes Piyush Mathur, MD from the Cleveland Clinic and Mitchell Goldburgh from NTT DATA speaking with CARPL CEO Vidur Mahajan, MD. 

• Improving the Patient Experience: How is Clearpath improving the healthcare experience for patients? Learn more about the company and its solutions for ditching the disc when sharing images and records with patients. 

• Visit United Imaging at ISMRM 2024: If you’re attending ISMRM 2024 in Singapore next month, be sure to visit with United Imaging in booth A18 to explore their latest advances in MRI technology and learn how United is shaping the future of healthcare through innovation. 

• Seamless Integration and Efficient Reading: TeraRecon’s latest Intuition advanced visualization solution now features seamless integration with Mirada Medical’s Mirada XD, providing efficient diagnostic reading with automatic multi-modality and multi-time point registration capabilities. Schedule a demo to learn more.

• Two Questions about AI for Radiology Leaders: Are today’s radiology AI solutions solving the right problems? And are there other solutions available for AI of brain MRI? Read this article from SpinTech MRI to learn how its STAGE solution can optimize MRI utilization. 

• Get to Know DeepHealth: DeepHealth offers a portfolio of AI solutions for clinical applications ranging from lung to prostate to brain indications. Learn more about DeepHealth and its AI-driven breakthroughs in care delivery.

• Revolutionizing Radiology with Clear Visual Intelligence: The University of New Mexico Hospital is partnering with Riverain Technologies to revolutionize radiology with the use of ClearRead CT with Clear Visual Intelligence for chest CT scans. Get details about the partnership on this page.

• Benchmarking AI – Building an AI Ecosystem: What are the best ways to deploy and optimize AI for radiology? Learn how by attending this May 8 webinar hosted by Bayer and featuring Lauren Nicola, MD, and James Blackwood on the value of AI in healthcare.