In June 2013, University Hospitals Case Medical Center (UHCMC) in Cleveland, Ohio, began feeding information from six of its 24 CT systems into a new dose-monitoring and reporting platform called Sectra DoseTrack™. Dave Jordan, senior medical physicist for the organization, explains that UHCMC turned on the system in early September, after feeding data to it for almost three months. “We were fortunate in that we were able to implement a system like this without a problem we needed to solve,” Jordan notes. “It wasn’t a response to a specific issue with radiation dose that we needed to solve—or a mandate we needed to meet.”

In “Discovering Emerging Value and Transaction Drivers in Imaging,” presented on September 9 in Boston, Massachusetts, at the 2013 RBMA Fall Educational Conference, three panelists from different corners of the imaging industry discussed the topic of emerging value and transaction drivers in the field. Elliott Jeter, CFA/ABV, is a partner with VMG Health; Arun Jethani is CEO of Medical Imaging Specialists; and Richard Townley is president and CEO of AGI Healthcare. The intersection of the panelists’ three perspectives reveals recent market changes affecting imaging-center transactions in 2013 and beyond.

When Saint Thomas Health (Nashville, Tennessee), a member of Ascension Health, decided to collaborate with locally headquartered practice Optimal Radiology Partners (ORP) on an outpatient joint venture, its primary motivation was providing more convenient service to patients and physicians, and, therefore, growing market share, according to Tom Blankenship, chief development officer for the partnership. “We also did our ambulatory surgical centers through joint ventures with physician partners,” he notes. “If you can find a partner who’s better at something than you’ve been able to be, that makes more sense than competing with it.”

As consolidation in the hospital market continues apace—driven by the increasing prevalence of integrated delivery networks (IDNs), accountable-care organizations, and other new payment/delivery models—many radiology groups find themselves at a crossroads. How can they gain the scale necessary to meet the mounting demands of today’s care continuum, given the continued downward pressure on reimbursement? RadAnalytics spoke with Bill Pickart, CEO of Integrated Medical Partners, about an emerging option that strikes a compromise between independence and scale, enabling groups to take a proactive approach to meeting hospitals’ evolving quality and service directives and needs.

Even in the wake of health care reform, radiology practices continue to struggle with managing payment from uninsured patients. The problem plagues hospital-based groups, in particular, according to Krista Pelensky, director of operations with Zotec-MMP. “Many hospital-based groups have seen an uptick in uninsured business and an increase in emergency-department services,” she says.

Few business processes for radiology practices are as fraught as negotiating managed-care contracts. Their duration and durability put a significant level of both current and future income on the line, but small and medium-sized practices, in particular, might feel that they have little leverage in the negotiating process. The keys to gaining the

Imaging Healthcare Specialists (“IHS”), a 30-radiologist practice based in San Diego, California, has a simple ethos driving its business decisions. “We view ourselves, first and foremost, as a medical practice,” Thomas Cleary, president and COO of Imaging Healthcare Specialists, explains. “Every day, every employee who works for us—from the person who schedules the patient, to the technologist who provides the exam, and from the radiologist delivering the report to the IT person—is making an impact on patients’ lives.”

The most common misconception regarding medical-practice reimbursement is that it’s about nothing more than money. In fact, reimbursement is about much more than the dollar numbers associated with CPT® codes in payors’ various fee schedules, and any discussion of it that doesn’t also touch on process, strategy, and service is incomplete.