Search
Featuring: Don Boshela, CT Product Marketing Manager for FUJIFILM Healthcare Americas Corporation
Did you know that heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States? In fact, someone has a heart attack every 40 seconds and one person dies every 34 seconds from cardiovascular disease. With troublesome statistics like these, it is clear that clinicians need every possible tool to combat heart disease in America.
A very powerful diagnostic tool gaining recognition and traction in diagnosing heart disease is coronary computed tomography angiography (CCTA). Earlier this year, Medicare reimbursement for CCTA doubled, increasing from approximately $175 to $357.13. This increase is due to the Centers for Medicare & Medicaid Services (CMS) reclassifying CCTA into a higher ambulatory payment classification (APC). The change aims to better alleviate financial pressure on providers and expand patient access to cardiac CT testing – all great causes that we applaud!
We talked with Don Boshela, CT Product Marketing Manager at FUJIFILM Healthcare Americas Corporation about the outlook for CCTA and best practices for hospitals seeking to implement a CCTA program.
If CCTA can help fight heart disease, why have providers traditionally been opposed to offering this imaging exam?
Boshela: Previously, one of the biggest barriers to adoption was low reimbursement. Most providers lost money on CCTA. Thankfully, with reimbursement now doubled, providers recognize that CCTA can be profitable.
Misconceptions around CCTA cost-effectiveness and radiation dose have also hindered CCTA adoption. Fortunately, research now clearly shows CT does not lead to higher downstream costs, and CT radiation dose has dropped by about 70% over the past 15 years.
The idea that CT Imaging equipment is expensive is another barrier. However, there are systems on the market to fit every facility’s size and budget. For example, some Fujifilm systems were built with community hospitals and outpatient practices and even remotely located rural providers in mind, where very tight capital budgets have found them highly cost-effective.
Since the improved reimbursement, have more hospitals launched CCTA programs?
Boshela: The only real data we have comes from 2022—prior to the bump in reimbursement, but I could imagine we will see new data soon as we are approaching the one-year mark since the new reimbursement.
According to the 2022 report, out of 391 safety-net hospitals identified in the U.S., 179 (45.8 percent) offer CCTA. That means that as of 2022 fewer than half of identified U.S. safety-net hospitals were found to provide CCTA for the evaluation of cardiac patients despite recent and growing evidence of its efficacy. That said, industry experts and medical societies, like the Society of Cardiovascular Computed Tomography (SCCT), anticipate a significant increase in the adoption of CCTA programs in U.S. hospitals as a direct result of the doubled Medicare reimbursement, but comprehensive data on the number of new programs is not yet available.
What can you tell us about the efficacy of CCTA and patient outcomes?
Boshela: In 2021, the U.S. Chest Pain guidelines elevated CCTA to a class 1A recommendation for the evaluation of acute and stable chest pain in patients without known CAD. The 2023 update in the Multimodality Appropriate Use Criteria (AUC) for chronic coronary disease rated CCTA “Appropriate” in nearly all symptomatic patient scenarios, a significant gain compared to the 2013 iteration. Patient outcome data is also positive. In a 2024 retrospective analysis, researchers found the adoption of CCTA led to over a six-day decrease in the average length of stay for patients in the ED-run Observation Medicine Unit at the Mayo Clinic Arizona in Phoenix. And today, CT is associated with an approximate 30% reduction in the rate of subsequent myocardial infarctions.
Based on the research studies and improved patient outcomes, it sounds like CCTA is clearly a proven modality that can help cardiac patients.
Boshela: That’s correct. Research shows that CCTA is a reliable and efficient diagnostic alternative to traditional non-invasive tests with high diagnostic accuracy contributing to faster decision-making and reduced need for invasive procedures. Simply put, CCTA can be a preventative and life-saving tool in cardiac care.
What advice do you have for hospitals that want to implement a CCTA program?
Boshela: I recommend focusing on five key action steps:
What’s the most important thing you want providers to know about launching a CCTA program?
Boshela: It can be a smart strategic move for your organization and a real advantage for cardiac patients. With careful planning, hospitals large and small can set themselves apart with a CCTA program that is no longer a “loss leader” but impacts patient outcomes and becomes a new revenue stream.