The Value of a Strategic Partner

Over the past five years, leaders on both the clinical and business sides of radiology have learned the hard way that adaptability and flexibility are prized qualities required for survival. Declining reimbursements, coupled with increased regulatory complexity (which is anticipated to deepen even further with the adoption of the ICD-10 changes), have forced decision-makers to re-evaluate every aspect of their business models and make the adjustments necessary to maintain viability. The ramifications of the implementation of the Affordable Care Act (ACA), despite its stumble out of the gate, have yet to be determined. Win or lose, however, there are increased administrative nightmares in store for radiology. Furthermore, the wild card in all of these changes is the increased radiology consumerism that has already necessitated adjustments in everything from operations to marketing. Consumerism has promoted the emergence of transparency in pricing and quality measures that will forever alter the way the business of imaging is conducted. Today, the development of a sound radiology business model requires decision-makers to understand that success lies along a new path, and that evolving payment models are here to stay. “It is incumbent upon radiology practice leaders to develop a practice vision in order to succeed,” says Bill Pickart, CEO of Integrated Medical Partners (IMP). IMP provides practice intelligence and enterprise management through a suite of solutions that includes decision support, workflow management, revenue cycle management, and strategic positioning. “Practices that anticipate and respond to the changes will have a much better chance of thriving, not just of surviving despite the upheaval we are experiencing,” he continues. Weathering Consolidation Through Stability The pressures on hospitals to create integrated delivery networks will continue unabated for the foreseeable future. Between 2001 and 2011, the number of physicians employed by hospitals across the US grew by more than 40%, according to the American Hospital Association. Add to this a recent report from the Medical Group Management Association that showed that in 2014, about 50% of U.S. doctors will be working for a hospital or hospital-owned health system. Such consolidation puts additional pressure on radiology enterprises. “Today, stability is the key to sustainability,” says Timothy Dyer, IMP’s executive vice president and CFO. “Stability is extremely valuable. In our case, our management team has lengthy tenure with IMP, which provides stability for our clients. IMP maintains stability for its client groups by adapting to the changing health-care landscape and giving our medical imaging clients useful, timely information with which to make important decisions.”   Dyer notes that now, more than ever, medical imaging enterprises need to manage their business affairs with keen eyes. “Between the Affordable Care Act, crippling reimbursement decreases, hospital affiliations, mergers and acquisitions, there is uncertainty," he says. "The decision-makers in these facilities have to know where they need to go and how to get there. Reliable RCM is just one element of a broader group of operational processes that must be under control and functioning properly. When that occurs, decision-makers can rely on their current numbers as a solid baseline for making strategic decisions. Without it, planning becomes arduous.” Planning via Analytics At each step along the provider care process, valuable data is available for collection and analysis. When this data is mined and managed, it can help provide the foundation for reliable forecasting to optimize strategic planning. “From the client’s perspective, financial stability necessitates continuity of information—actionable information—plus consistent and predictable cash flow,” says Robert J. Kebbekus, IMP’s president and COO. “The key today is for medical imaging leaders to focus on daily, weekly and monthly performance and compare it with forecasted goals,” he continues. ”By proactively managing and reporting on variances, course corrections can be made before problems become irreversible. At IMP, we make it our business to know the ‘why’ of an issue while others are still trying to figure out whether there is an issue. Providing communication to multiple levels of management within our clients’ practice or enterprise to make sure the correct messaging is delivered helps them stay out in front of any challenges to their RCM.” For Kebbekus, one difference between smooth operations and uncertainty is the talent pool. “Most of the uncertainties are related to changes in reimbursement. Everyone here at IMP, from the management team on down, is keenly focused on CMS and payors," he says. "That focus helps us overcome the uncertainties and helps our clients build a successful strategy to remain relevant.” Advice from Experts At a time when change and uncertainty are commonplace, what should medical leadership be doing to minimize risk and maximize opportunities? “To start, minimize risk by controlling the environment as best you can. A medical imaging business can do so by utilizing a highly customizable RCM software that is continuously improved and enhanced according to the changes in health care,” says Dyer. “The practice should look for reporting packages that are specifically tailored to the particulars of its operation and include interactive ‘drill down’ capabilities, all the way down to patient level.  “Next, they need an RCM resource that provides executive leadership from a team that promotes a strategic practice or enterprise understanding beyond billing," he continues. "That’s a key element of our support.”  Kebbekus adds that while strategic planning is essential, smooth daily operations are necessary to help achieve any goal. “Practice leaders must insist on full capture of the work performed by the physician, and their RCM resource must make sure the group is paid correctly by the payors," he says. "At IMP, it is standard operating procedure to improve the understanding of the new coding changes and the quality of the group’s documentation to optimize the group’s reimbursements, as is capturing and resolving denials by insurance companies so the group gets every dollar they deserve.” As medical imaging faces more surprises and more uncertainty, imaging leaders need a partner that will enhance their practice. “At IMP, we understand our primary mission is to support our medical imaging clientele so that they can make proactive, positive changes and control their own destiny,” says Kebbekus, “which means the difference between their relevancy and relegation. “Quite simply," he concludes, "it means providing vision—nothing less.”