Be Careful What You Ask For

As the dust begins to settle on the legislative action that has imaging center owners in various states of confusion, angst, and anger, it is clear that no one saw this particular train wreck coming. Questions remain at virtually every level of influence within the industry about who, why, what went wrong and what to do about these devastating reimbursement cuts. Which started me thinking about the survivors of the train wreck. Surely there will be survivors, yes? Indeed, there will be plenty. As each of us in recent years has lamented the surge in self referral and the introduction of marginally qualified IDTF “bottom feeders” into most markets, the capable and strong outpatient imaging organizations who were doing it the right way (quality focused, outcomes based, service oriented) have been increasingly distracted by these marginal players. And as every investor in the stock market eventually figures out, with each market “correction” comes a buying opportunity. Those capable of being aggressive and investing for the long term will definitely see tremendous opportunity in the coming imaging “correction” of 2007. There will be deals to be made. Now that the assessments have been done about the short term impact to imaging center organizations, it is time to reflect on the fact that it is just possible that this correction will naturally weed out the weak providers and those only in it for the technical dollars that have been the low hanging fruit of diagnostic imaging. The fact remains that the projected growth in imaging within the country’s overall health expenditures will not only continue its robust growth rate, but is projected to increase as an overall percentage of these expenses. This is indeed good news for those ready to meet the challenges of declining reimbursement head on. There will be money to be made. The winners will become better in the marketplace of ideas and service. They will see a revenue hit as a chance to find increasingly creative ways of adding new revenue lines (think vascular ultrasound or outpatient interventional procedures, for example). It just could be that this severe blow from Congress will make it significantly less attractive for the marginal players and the self referrers. Granted, like many things in medicine, the cure will be painful, but it just might be the best way to shake the market out and allow the quality providers to thrive. It is unfortunate that the good guys will also get hurt, but how often have you asked yourself what price you would be willing to pay to eliminate a bad competitor or a self referral threat. Just as the introduction of prospective payment DRGs were going to “put the industry out of business” in 1983, we will likely look back on this 2007 correction as nothing more than a chance to sharpen our focus and grow through gaining market share.