October/November 2013

June, a month long prized by brides, had a strong matrimonial pull on health-care providers, with a pair of announced mergers/acquisitions that created two massive health systems, one for profit and one nonprofit. Several other key mergers announced and expected to be completed this year highlight the diversity of the hospital players and their deals, but all share a common denominator: There is a pervasive ambition to grow.

Ask any health–IT executive for a synonym for change, and a probable response is merger/acquisition. The rapid pace of consolidation among physician practices, individual hospitals, hospital enterprises, and hospital-chain corporations has generated an unprecedented level of organizational, operational, and technological change.

Reimbursement cuts, market consolidation, and health-care reform have sparked significant changes in the imaging-technology strategies being implemented across the radiology landscape. Practices, imaging centers, and hospital radiology departments alike not only are altering the manner in which they formulate decisions on imaging-equipment acquisition, but also are adopting different approaches to demonstrating the need for new technology, to acquiring capital for equipment purchases, and to maintaining the assets that they already have.

From the man who imprinted the definition of value on health care’s collective forehead comes a prescription for the rescue of global health: Business guru Michael E. Porter (with Thomas H. Lee)¹ shares “The Strategy That Will Fix Health Care” in the October issue of Harvard Business Review. The article builds on everything that Porter has written on health care in the past to provide a solution with sheer simplicity at its center: Maximize value for patients by achieving the best outcomes at the lowest cost.

The Inland Northwest, which we call home, is fortunate to have a legacy of health-information sharing among many organizations. These include the 97-radiologist private practice Integra Imaging (Spokane, Washington), formed through the merger of Inland Imaging and Seattle Radiology. Integra Imaging’s PACS archives host images for more than 100 sites.

Some observers have commented on the narrow networks associated with many insurance products being offered by the state and federal insurance exchanges mandated by the Patient Protection and Affordable Care Act (PPACA). A new survey¹ of members of the Medical Group Management Association (MGMA) suggests why insurers may be having trouble attracting broader physician panels. The MGMA received more than 1,000 responses from practices representing more than 47,500 physicians.

On July 16, 2013, CMS announced the results¹ of its accountable-care organization (ACO) program, the Pioneer ACO Model. The program was designed to test the impact of higher levels of shared savings and risk on ACO success, and it attracted 32 participants from around the country. After the first year of participation, seven Pioneer ACOs that did not produce shared savings announced their intention to transition to the lower-risk (and lower-reward) Medicare Shared Savings Program, while two dropped out of the ACO model entirely.

I read with interest the recent article by Cynthia Keen, “When a Hospital Replaces a Private Practice.”¹ The featured group is portrayed as an example of the type of practice that currently is being replaced by teleradiology companies. Poor customer service, substandard turnaround times, suboptimal call coverage, and lack of peer review are among the alleged failings.