Journal of Cardiovascular Computed Tomography最新文献

{"title":"Regional and socioeconomic disparities in calcium scans","authors":"Vincent Sachs ,&nbsp;Christopher Scoma ,&nbsp;Kashif Shaikh ,&nbsp;Matthew Budoff ,&nbsp;Shone Almeida","doi":"10.1016/j.jcct.2024.08.002","DOIUrl":"10.1016/j.jcct.2024.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Disparities in cardiovascular care are well recognized, with socioeconomic status being one of the strongest determinants of cardiovascular disease outcomes. This study evaluates whether these disparities translate to coronary artery calcium (CAC) scan utilization. Specifically, we aim to describe regional variation and socioeconomic variables that impact CAC utilization across the United States relative to the prevalence of coronary artery disease (CAD) and related comorbidities.</div></div><div><h3>Methods</h3><div>This cross-sectional study integrates county-level CAC utilization with CAD prevalence and publicly available socioeconomic variables including self-identified ethnicity, education, and adjusted gross income. CAC utilization rates were sourced from 2022 hospital commercial claims, outpatient Medicare service claims, and independent imaging center claims. Heart disease prevalence and socioeconomic variables were extracted from the Centers for Disease Control and Prevention and the National Center for Chronic Disease Prevention and Health Promotion. Adjusted gross income per capita was gathered from Internal Revenue Service data.</div></div><div><h3>Results</h3><div>CAC utilization was evaluated across 808 counties within the United States, representing 600,379 claims. Median utilization was 1.62 scans per 1,000 persons with a range of 0.03 to 104.39. The West had the highest CAC scan utilization rate (median 3.09 scans per 1,000 persons) with a CAD prevalence of 548 per 100,000 persons. In contrast, the Midwest had the lowest utilization rate (median 1.24 scans per 1,000 persons) with a CAD prevalence of 635 per 100,000 persons.</div><div>Socioeconomic factors that favor higher CAC utilization include a larger density of White/Caucasian ethnicity (p = 0.007) and a higher adjusted gross income per capita (p = 0.006). Counties with the lowest rates of CAC utilization have a higher population of African Americans (p &lt;0.001) and a higher proportion of females (p &lt;0.001).</div></div><div><h3>Conclusion</h3><div>This analysis highlights regional and socioeconomic differences in CAC utilization in the United States. Under-represented ethnicities such as African Americans have among the lowest rates of CAC utilization despite having a higher burden and mortality from heart disease. Discordance between CAC utilization, heart disease prevalence and socioeconomic status reveals a need for targeted interventions and policies aimed at mitigating structural barriers that perpetuate health inequities.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Pages 169-172"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac CT angiography: Financial implications of different practice types","authors":"Monvadi B. Srichai ,&nbsp;Ron Blankstein ,&nbsp;Sylvia Lesic ,&nbsp;Michelle C. Williams","doi":"10.1016/j.jcct.2024.08.005","DOIUrl":"10.1016/j.jcct.2024.08.005","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Pages 132-138"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SCCT Health Policy and Advocacy Efforts","authors":"Mark G. Rabbat ,&nbsp;Jonathan R. Weir-McCall","doi":"10.1016/j.jcct.2024.09.003","DOIUrl":"10.1016/j.jcct.2024.09.003","url":null,"abstract":"<div><div>Cardiac computed tomography has a growing presence in multiple guidelines supported by a growing evidence base as to its accuracy and impact on clinical outcomes. Despite this, dissemination into widespread routine clinical practice has been slow, largely restricted to large academic centers and urban settings. The reasons of this are multifactorial, but one of the most impactful of these reasons is undeniably reimbursement. Currently, there is marked discrepancy between the costs of performing cardiac CT and the renumeration provided for this. Until this is addressed, cardiac CT will not reach its potential for the benefit of patients. It is for this reason that the SCCT continues to dedicate significant efforts to represent the need of the cardiology and radiology communities in bringing about changes in policy and billing. Significant momentum has been gained in recent years with the engagement of both congress and Medicare in moving towards a system of payment that recognizes the time and expertise required to acquire high quality cardiac CT. In this article we cover these recent efforts, and the next steps in this continued effort over the coming years.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Pages 103-105"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a successful cardiovascular computed tomography service: Financial and regulatory challenges facing radiologists and cardiologists","authors":"Ahmad Slim ,&nbsp;Cristina Fuss ,&nbsp;Ed Nicol","doi":"10.1016/j.jcct.2024.09.012","DOIUrl":"10.1016/j.jcct.2024.09.012","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Pages 89-92"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability in technical fee billing for cardiac CT across congenital cardiac centers","authors":"Spencer Barfuss ,&nbsp;Corinne Ballard ,&nbsp;Bethany Marullo ,&nbsp;Jake Zimmerli ,&nbsp;Luke Linscott ,&nbsp;Cody Coonradt ,&nbsp;B. Kelly Han","doi":"10.1016/j.jcct.2024.12.089","DOIUrl":"10.1016/j.jcct.2024.12.089","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac Computed Tomography (CCT) is increasingly used to provide 2D, 3D and 4D information in patients with congenital heart disease of all ages. Historically, negotiated rates for professional and technical fees associated with cardiac imaging were confidential, with variability in professional, technical and global charges, reimbursement and cost to patients for the same current procedural terminology (CPT) code at different institutions. Billing transparency is a key component of both the CARE act passed in 2020 and the Health Care PRICE Transparency Act 2.0 passed in 2021. Institutional technical fees and negotiated insurance rates by CPT billing code are now publicly available and can be compared between institutions.</div></div><div><h3>Methods</h3><div>A cohort of congenital heart disease programs was identified as the top 50 programs by procedural volume (Society of Thoracic Surgeons database) and by national rankings (US News and World Report). The publicly available negotiated reimbursement rates for the technical component of billing for CPT codes used for CHD CCT (75572, 75573, and 75574) at each center was determined (trybilly.app). The cash price, average insured price and the range of negotiated insured prices for the technical component of CHD CCT were recorded. The variability of technical fee charges for programs were calculated as median, IQR and range. Technical fee correlation to RVUs was also calculated. Professional fee and global procedural fees are not available for comparison.</div></div><div><h3>Results</h3><div>For the 75572 code, the median charge was $1209.50, IQR (783.50, 1673.75), and range was (49,2618). For the 75573 code, the median charge was $958, IQR (718,1403), and range (60,2622). For the 75574 code the median charge was $1060, IQR (833.5,1604), and range (61,2948). There was a 53-fold difference in technical fee charges for C CT between low and high negotiated insurance prices. Charges for CCT in CHD were not correlated with US News rankings or surgical center volume. There was no correlation between RVUs and technical fees.</div></div><div><h3>Conclusion</h3><div>There is significant variability in the charges for the technical component of CCT in CHD, not correlated with national ranking or surgical volume. Variability in charges for identical services across centers may have a disproportionate impact on uninsured and underinsured populations. and lead to inequity. This data may inform negotiations for reimbursement for this time-consuming skill set. The variability of technical fee associated with CT for CHD has not been previously analyzed or compared by national ranking or surgical volumes.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Pages 97-102"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The business aspect of cardiac CT","authors":"Armin Arbab-Zadeh","doi":"10.1016/j.jcct.2024.12.086","DOIUrl":"10.1016/j.jcct.2024.12.086","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Pages 86-87"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SAVE THE DATE_4C_FP","authors":"","doi":"10.1016/S1934-5925(25)00030-9","DOIUrl":"10.1016/S1934-5925(25)00030-9","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Page OBC"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ffrct Derived Coronary Physiological Pattern and Graft Patency in the Fasttrack Cabg Trial","authors":"T. Tsai ,&nbsp;S. Kageyama ,&nbsp;P. Murphy ,&nbsp;D. Keulards ,&nbsp;A. Updegrove ,&nbsp;C. Taylor ,&nbsp;M. Sinclair ,&nbsp;S. Mullen ,&nbsp;C. Rogers ,&nbsp;S. Garg ,&nbsp;A. Chinhenzva ,&nbsp;J. Puskas ,&nbsp;J. Narula ,&nbsp;K. Tanaka ,&nbsp;J. De Mey ,&nbsp;M. La Meir ,&nbsp;T. Doenst ,&nbsp;S. Mushtaq ,&nbsp;G. Pompilio ,&nbsp;G. Pontone ,&nbsp;P. Serruys","doi":"10.1016/j.jcct.2024.12.006","DOIUrl":"10.1016/j.jcct.2024.12.006","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Pages S1-S2"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Coronary Atherosclerosis Assessed By Cardiac Ct in Patients With and Without a Family History of Ischemic Heart Disease: The Frater Study","authors":"E. Conte,&nbsp;D. Marchetti,&nbsp;M. Schillaci,&nbsp;A. Ratti,&nbsp;A. Provera,&nbsp;E. Melotti,&nbsp;M. Doldi,&nbsp;D. Andreini","doi":"10.1016/j.jcct.2024.12.062","DOIUrl":"10.1016/j.jcct.2024.12.062","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Page S23"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Arterial Blood Gas Parameters in Patients With Pulmonary Embolism Confirmed by Using Computed Tomography Pulmonary Angiogram","authors":"Z. Hwang ,&nbsp;A. Musa","doi":"10.1016/j.jcct.2024.12.046","DOIUrl":"10.1016/j.jcct.2024.12.046","url":null,"abstract":"","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"19 1","pages":"Pages S17-S18"},"PeriodicalIF":5.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}