Nuclear cardiology in hospital-based practice.

Managed care has drastically changed the environment in which we practice hospital-based nuclear cardiology. As of 1995, traditional fee for service comprises only 8% of all reimbursement in the United States. Nuclear cardiology is now a cost center, not a revenue center, for the hospital. In Minnesota, many physicians and hospitals work together toward common goals in various "integrated health service networks." There are several ways in which nuclear cardiology can help a health care network reduce costs. Results of myocardial perfusion, for example, can be used to help reduce unnecessary coronary angiography and revascularization procedures. On the other hand, nuclear cardiology is generally not cost-effective in patients with a low likelihood of benefitting from the test and should usually be avoided in such patients.