A Foundational Guide to Understanding Radiology Department Business Operations for Trainees |
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| Affiliation: | 1. Professor of Emergency Medicine; Chief, Section of Emergency Ultrasound;2. Director of Pediatric Neuroradiology, Department of Radiology, Children''s Healthcare of Atlanta, Director for Quality, Department of Radiology, Children''s Healthcare of Atlanta, Associate Professor, Emory University School of Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;3. Medical Director Sutter Physicians Network, Medical Director Quality and Safety, Neuroradiologist, Sutter Medical Group—Sutter Medical Network, Sacramento, California;4. Hackensack Radiology Group; Board member, Hackensack Meridian Health Partners Clinically Integrated Network; Finance Chair, Hackensack Meridian Health Partners Clinically Integrated Network; Hackensack Radiology Group, Hackensack, New Jersey;5. American College of Radiology, Reston, Virginia;6. Chief, Section of Administration and Associate Professor, Department of Emergency Medicine at Yale University School of Medicine and Scientist at the Yale New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, Connecticut;1. Liberty Hospital Women''s Imaging, Department of Radiology, Liberty Hospital/Alliance Radiology, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;2. Department of Radiology, AdventHealth Medical Group, Orlando, Florida;3. Quantum Radiology, Atlanta, Georgia;4. Divisional Wellness Lead, Division of Diagnostic Imaging, Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas;1. Professor and Vice Chair-Faculty Affairs, Department of Radiology, University of Pittsburgh and UPMC International. Chief Medical Officer, The Radiology Leadership Institute and Chair of the Commission on Leadership and Practice Development of the American College of Radiology, Reston, Virginia;2. Chair of the Executive Committee, and Chair of Clinical Operations, Triad Radiology Associates, Winston-Salem, North Carolina;1. Envision Imaging Medical Director and Recruitment Chair, Radiology Associates of North Texas, Fort Worth, Texas; Assistant Professor, Clinical Sciences, Texas Christian University and University of North Texas Health Science Center School of Medicine, Fort Worth, Texas;2. Division of Radiology and Biomedical Imaging, College of Human Medicine, Michigan State University, Grand Rapids, Michigan;3. Vice President of Clinical Operations and Quality Chair, Advanced Radiology Services, Grand Rapids, Michigan;1. Vice Chair of Clinical Operations and Informatics, Division Chief of Musculoskeletal Imaging and Intervention, and Associate Chief Medical Information Officer, Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia;2. Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia;3. Business Office Manager, Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia;4. Chair of the Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia |
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| Abstract: | The financial success of a radiology department is crucial to the well-being of both the hospital and the community it serves. Radiology trainees should therefore be conscious of how the department maintains its value within the health system. The purpose of this review is to provide a concise foundational resource for contemporary radiology residents and fellows to understand the basic financial operations of a hospital-based radiology department and to demonstrate its importance in supporting clinical activities. The radiology report is at the heart of reimbursement. Coders use this tool to assign International Classification of Diseases and Current Procedural Terminology codes to file reimbursement claims. Medicare, commanding the highest market share for third-party payers, sets algorithmic standards for compensation practices. Private insurers contract with hospitals, and providers use these systems or create their own contractual framework. Radiology leaders strategically balance these revenue streams with various departmental costs utilizing tools such as budgets and forecasts to ensure long-term organizational viability. Notably, payment practices in the United States are transforming from fee-for-service to value-based care. The roles of the radiologist and the radiology report are evolving with it. Examples of value-based payment models are accountable care organizations and bundled payments. Radiologists participating in these models are increasingly expected to be stewards of imaging utilization and effectively manage health care resources. Within this context of a globally changing incentive structure, trainees must reconceptualize their educational experience to equip themselves for both current and future types of clinical practice. |
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| Keywords: | Health care economics health policy radiology finance reimbursement resident education |
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