Imaging industry group concerned about paltry insurance payment rates
The medical imaging industry is raising concerns that ongoing reimbursement pressures and prior authorization requirements are threatening access to advanced technology and making people think twice about going into medicine as a profession.
Rich Fabian, chair of the board for AdvaMed Imaging, spoke with Radiology Business during the Radiological Society of North America (RSNA) 2025 meeting in December. He said reimbursement has become an increasingly urgent issue for providers and manufacturers alike.
Fabian argued that the value delivered by modern imaging is often overlooked.
“What imaging provides is a large amount of information needed for the delivery of therapy. It's unparalleled. If you take a look back just a few years ago, instead of imaging, they were doing exploratory surgery. Can you just imagine that?” he said. “The value that's delivered through imaging is incredible, and we are seeing a constant battle and fight for reimbursement that we think is unwarranted because the value that we are delivering is incredible.”
Healthcare organizations across imaging, cardiology and orthopedics report that declining Medicare payments—driven in part by budget neutrality requirements—combined with growing prior authorization hurdles from private insurers are putting pressure on departments already grappling with staffing shortages.
Industry leaders warn that continued payment reductions could have downstream effects on capital investment and workforce recruitment. Hospitals facing tighter margins may delay or forgo purchases of new imaging equipment, potentially limiting access to the latest advances in artificial intelligence, faster acquisition times and lower-dose technologies.
“Also, you want to make sure you're able to attract and retain talent, have access to newer equipment, and you're not going to get that. When we continue to drive down reimbursements year after year, you're going to see hospitals not buying the latest equipment, not being able to provide better technology for their physicians and for their patients,” Fabian said. “And it's going to make it more difficult to attract top people into these areas of radiology, interventional radiology, where we really want some of the best of the best to be fighting for these slots.”
Recruiters and health systems say access to advanced imaging platforms also is increasingly important to clinicians, who cite workflow efficiencies and AI-enabled tools as factors that can improve work-life balance and patient throughput.
Fabian said demand for new systems is driven not by aesthetics, but by clinical need and performance gains.
“They don't want a new imaging system because they just want a brand new, shiny piece of equipment. They want it because of the value it delivers. The reality is the reason they want that ultrasound, MRI or CT, whatever the piece of equipment is, is because it fulfills a clinical duty and the newer equipment can do it better, faster, cheaper than the older equipment, and we can treat more patients in a way we've never been able to,” Fabian explained.
AdvaMed Imaging officials say they will continue engaging policymakers to highlight imaging’s role in improving outcomes and reducing the need for more invasive procedures, while pushing for reimbursement policies that reflect the technology’s clinical and economic value.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]