My guess is that the add-on fee will go wherever the technical component of the scan's fee goes, ie, whoever owns the scanner and employs the technologists, as they are likely the ones paying the Viz.ai subscription fee. That's usually the hospital, especially as these are emergency department patients and not some other outpatient imaging center. Then the dispersement comes down to whatever general financial arrangement the hospital has with the radiology group, like whether the radiologists are employed or contracted. It'll filter down eventually and create the same incentives as if the radiologists were getting the money. Just look at how all radiology practices choose to add on CAD to mammography even though many radiologists don't find it useful and it takes up time to review. It's for collecting money from the payor (until 2017, CAD was an add-on code; now it's ubiquitous and bundled in). In the Viz.ai situation, it's a win-win for the primary hospital's radiologists: you no longer have to rush to read stroke code CTAs and you (indirectly) get paid for it. If I understand correctly, the reimbursement is not going to the tertiary hospital's interventionalist who now has to do a wet read on their cell phone app to determine whether the AI was right or not and then call the access nurse to coordinate transfer. Sounds like a raw deal unless there is some money flow where primary stroke center (the OSH where the radiologist is) pays to affiliate with a comprehensive stroke center (where the interventionalist is) to send patients.
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