Enterprise Imaging Podcast Interoperability Radiology

Flight Path Ep. 5: Mitchell Fong on where imaging fits in rural health's $50B reset

Mike Moore October 20, 2026

Flight Path Episode 5 thumbnail with Mitchell Fong of Innovise Consulting

Mitchell Fong, Founder and CEO, Innovise Consulting. Hosted by Mike Moore. Runtime 30:45.

 

Episode summary

This is the year rural health finally has the country's attention, and the money to match it. The Rural Health Transformation Program is putting fifty billion dollars into rural care over five years, and year one has been a scramble. Mitchell Fong has spent his career making care work in places most vendors used to skip, first as VP of Virtual Care at Renown Health, building telehealth across northern Nevada, Lake Tahoe, and northeast California, and now as founder and CEO of Innovise Consulting.

His central message: build for year six, not just year one. It's tempting to buy a stack of point solutions while the funding is here, but the operators who win will be the ones who start with a strategy and keep their eyes on the whole ecosystem. Imaging has a specific and often underappreciated place in that plan. Most services in a critical access hospital run on cost-plus reimbursement; imaging is one of the rare places a rural facility can turn a real fee-for-service margin, which helps subsidize the rest of the care it provides.

But that margin only holds if the image is worth something once it leaves the building. When priors don't travel, the urban specialist repeats the scan, the payer pays twice, and the patient starts a new relationship by redoing a test they already sat through. Mitchell and Mike get into why the fix isn't always another machine. Often it's the interoperability layer that lets a local scan be read where the specialist sits, so care and revenue both stay local.

In this episode

  • Why year one of rural health transformation is really a five-year strategy question, and the trap of buying one-off point solutions
  • Imaging as a rare rural profit center: fee-for-service margin versus cost-plus on almost everything else
  • The repeat-scan tax: how lost priors and low-fidelity studies drive redundant imaging and double payments
  • Teleradiology, priors, and the interoperability layer that keeps care and revenue local
  • Vendor overload: why rural operators are suddenly the most courted clients in healthcare, and how to filter the noise
  • Old tech, new tech: portable X-ray, point-of-care ultrasound, and the regional hub-and-spoke case for big capital like MRI and CT
  • Workforce readiness and change management as the make-or-break of any rural technology plan
  • Where imaging should sit when a rural CEO or CIO sits down to write their plan

Chapters

  • 0:00 Welcome to Flight Path
  • 0:40 Meet Mitchell Fong: rural health's moment
  • 1:17 Building virtual care across Nevada, Tahoe, and northeast California
  • 4:36 Every rural community is different
  • 5:44 Where imaging fits: getting upstream with diagnostics
  • 7:00 Imaging as a rural profit center
  • 8:04 The repeat-scan tax: redundant imaging and double payments
  • 9:53 Teleradiology, priors, and the interoperability layer
  • 12:12 Year one: tactical versus strategic, and vendor overload
  • 17:27 Quick wins versus the five-year roadmap
  • 20:03 Old tech, new tech: portable X-ray, POCUS, regional MRI/CT
  • 22:25 Workforce readiness and change management
  • 27:26 Final advice: where imaging sits in the plan
  • 29:47 How to reach Mitchell and close

In their words

“The specialist needs the best image to deliver the best care. Particularly if they're doing that virtually.”

“Imaging is an area where, on a fee-for-service basis, you can actually have a healthier margin.”

“Build something that's sustainable beyond the five years.”

About the guest

Mitchell Fong is the founder and CEO of Innovise Consulting. He previously served as Vice President of Virtual Care at Renown Health, where he built telehealth programs across northern Nevada, Lake Tahoe, and northeast California. He advises digital health companies and works with rural and health-system leaders on virtual care, population health, and technology strategy.

Read the companion piece

Imaging is one of the few places a rural hospital can still turn a profit. Here's how not to waste it. covers the repeat-scan tax, why the fix is usually reach rather than another machine, and three questions for anyone writing a rural imaging plan.

About Flight Path

Flight Path is Mach7's show about where healthcare imaging is going and the people helping it get there, hosted by Mike Moore. New episodes every other Tuesday.

Follow so you don't miss the next one: YouTube · Spotify · Apple Podcasts