CCTA programs need a strategic C-suite case to drive growth and efficiency
Coronary CT angiography (CCTA) programs should be viewed as strategic cardiovascular assets rather than simple diagnostic services, according to Ginger Biesbrock, DSc, PA-C, MPH, FACC, senior vice president of the National Heart and Vascular Service Line at Advocate Health, in the above video interview with Cardiovascular Business.
Speaking at the Society of Cardiovascular Computed Tomography (SCCT) 2026 meeting, Biesbrock said health systems need to evaluate advanced cardiovascular imaging through the lens of demand, capacity and its impact on downstream cardiovascular services.
“Where we don't have access is where we have challenges around growth and appropriate management in our clinical programming,” Biesbrock said. She added that access issues to CT can impact programs for structural heart, electrophysiology, interventional cardiology and cardiac surgery.
For administrators, she said the business case begins with understanding how efficiently CT capacity can be used. Quality and appropriate staffing are foundational, but dedicated cardiovascular CT scanners can substantially increase throughput when sufficient demand exists.
Advocate Health has concentrations of hospitals and clinics in North Carolina, Georgia, Illinois and Wisconsin. Biesbrock said some cardiovascular-only CT scanners perform up to 23 scans per day, with operating hours extended to as long as 12 hours a day, six days a week. Compared with traditional shared-use models, she said this approach has increased capacity by roughly one-third and, in some cases, by 40% to 50%.
The CCTA efficiency strategy also requires attention to scheduling and patient navigation. Minimizing delays and no-shows helps make throughput more predictable. This also allows programs to increase volume without compromising quality or the patient and staff experience.
Biesbrock said the financial value of CCTA extends well beyond the revenue generated by the CT examination itself. Her organization examined downstream effects in the cardiac catheterization laboratory and found that CCTA could reduce the number of diagnostic-only catheterizations. Patients whose CT scans ruled out significant disease often did not proceed to the cath lab, while those who did proceed were more likely to require an intervention. As a result, some cath labs saw the proportion of percutaneous coronary intervention (PCI) cases rise to 60% to 70% for their case mix among patients who had undergone prior CT imaging. She noted that reimbursement is higher for PCI than diagnostic caths, so CCTA helped make better use of the cath labs.
That shift translated into a broader financial impact. Biesbrock said that when Advocate compared the overall direct contribution margin of a cath lab before and after the evolution of its CT program, some labs saw increases of as much as 40%.
“When you start to do that sort of math, suddenly the value proposition around CT goes much farther than just what we saw in the original pro forma related to CT revenue versus CT expense,” she said.
For cardiologists seeking to establish or expand a CCTA program, Biesbrock recommends bringing administrators a quantified assessment of demand and expected utilization, rather than focusing solely on the clinical benefits. She said CCTA's expanding use cases can also strengthen that argument. In addition to chest pain evaluation, CT is increasingly used for structural heart procedural planning and EP applications, creating additional potential demand for scanner capacity.
“Show me the patients, show me where that need is, and as much as we can, quantify that so we can put that into our pro forma,” Biesbrock said.
The final piece is operational efficiency, which requires close collaboration between clinical and administrative leaders. Physicians do not need to become operations experts, she said, but understanding the key factors that determine scanner utilization and throughput can help clinical leaders and administrators maximize the value of capital investments.
That partnership, Biesbrock said, can transform CCTA from a diagnostic service into a strategic component of cardiovascular program growth and financial performance.
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]