Utilization Management of Cardiovascular Imaging. Pre-Certification and Appropriateness

Robert C. Hendel

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


Rapid technological advances with enhanced clinical application have promoted the utility as well the growth of cardiac imaging. However, this has also raised concerns about over-utilization and inappropriate use in imaging. The imaging community, which initially took pride in increasing imaging volume, now fears limited access and reduced reimbursement. Nonclinicians, i.e., payers, have become gatekeepers to cardiac imaging, with decisions often lacking firm foundation within medical literature. The near-ubiquitous presence of radiology benefits managers is clearly impacting on the use of cardiac imaging, often through an indiscriminant reduction in imaging volume. Medical societies and clinicians were slow to respond to spiraling costs of cardiac imaging, but now recognize the need to promote appropriate and cost-conscious use of imaging. Through the development of guidelines and appropriateness criteria, physician-directed efforts are focused on eliminating unnecessary testing and promoting increased awareness of health care costs. This paper attempts to review some of the current issues concerning the responsible use of cardiovascular imaging.

Original languageEnglish (US)
Pages (from-to)241-248
Number of pages8
JournalJACC: Cardiovascular Imaging
Issue number2
StatePublished - Mar 2008

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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