Radiology practice prepares to ditch hospital partner 3 years before new contract ends
A Connecticut radiology practice is preparing to ditch its hospital partner three years before their new professional services agreement is slated to end.
Danbury-based Advanced Imaging Specialists first negotiated a deal with Trinity Health in early 2024. The pact had the practice serving as exclusive provider of diagnostic and interventional services for Trinity’s Saint Francis, Johnson Memorial, and Mount Sinai hospitals in Connecticut.
Their agreement wasn’t set to expire until September 2029, but after beginning work at the three facilities, Advanced Imaging Specialists has changed its mind. The radiology group is now prepared to end their relationship this March, after previously suing the hospital system in November, the Hartford Courant reported Monday. In the lawsuit, AIS claims Trinity Health has “significantly mismanaged” its radiology department while making “material misrepresentations” about its operations.
“This is not something that you can solve with [the hiring of] one or two people,” a radiologist who declined to be identified tells the newspaper. “I can’t imagine coming up with a solution for coverage in less than three months. They aren’t looking out or serving the best interests of the community.”
Meanwhile, a representative for Trinity Health emphasized that it expects imaging-related services to continue uninterrupted at its facilities. The hospital system is now “actively and carefully managing the radiology transition” with an eye toward ensuring “continuity of care for our patients and community,” the Courant reports.
The contract dispute also has drawn the attention of state Sens. Jeffrey Gordon, MD, and Saud Anwar, MD, who last year spoke out about staffing issues at Jefferson Radiology, another Connecticut imaging group. Anwar, a Democrat and practicing pulmonologist, believes both Department of Public Health oversight and regulatory changes may be required to address issues at the Trinity facilities.
“Lack of radiology [services] would make the health system nonfunctional,” Anwar, who also co-chairs the state’s Public Health Committee, tells the newspaper. “Radiologists are one of the most important parts of timely diagnosis and critical management and follow-up. Having no radiologists would place timeliness and time management at risk.”
More on the original complaint
As reported last fall, Advanced Imaging Specialists signed the contract with the expectation it would have adequate facilities, staffing, supplies and equipment. AIS further charged that Trinity underrepresented the number of radiologists required for breast imaging. Plus, its callback rate for screening mammograms was “far below national CMS guidelines,” and the hospital system allegedly has failed to ensure adequate staffing, among other allegations.
Further, Trinity Health of New England’s overnight radiology services generate “substantially less” than fair market value, falling below the previously estimated amount of $200,000 per month. Trinity Health also had a preexisting exclusive arrangement with its prior radiology provider for all outpatient imaging, which limited Advanced Imaging Specialists’ ability to generate revenue, the lawsuit says.
Upon discovering these issues, the radiology group “promptly and diligently” communicated with Trinity management to find a solution. Their agreement requires the hospital system to settle any claims or controversies through “negotiation in good faith and timely escalation to the appropriate higher-level managers and executives.” The radiology group has reportedly communicated with the hospital about these staffing shortages, lack of equipment and “insufficient revenue generation.”
They’ve executed three amendments to the contract, with AIS securing monthly “support payments” from Trinity as partial compensation for the shortfall.
“In providing such payments, Trinity Health recognized that AIS incurred significant losses as a result of Trinity Health’s conduct in connection with the provision of interventional radiology services under the agreement,” the complaint states.
AIS has “repeatedly” proposed various solutions to resolve the outstanding issues. Options have included buying software related to both virtual coronary CT angiography and prostate MRI, revenue generating workflow modifications, and financial negotiations to support AIS’s ability to continue administering imaging services.
“Trinity Health has refused to engage in good faith negotiations, including failing to respond to AIS’s inquiries, failing to connect AIS with Trinity Health personnel with decision-making authority, and failing to cooperate in scheduling and attending negotiation meetings,” the lawsuit charges. “Despite AIS’s good faith efforts and despite Trinity Health’s continued acceptance of the radiology services rendered by AIS under the agreement, Trinity Health has not addressed any of the issues raised by AIS.”
As a result of Trinity’s “material misrepresentations” and “failure to cure the issues,” AIS is losing $400,000 a month on the agreement. As of November, it had sustained damages greater than $3.2 million because of the hospital system’s alleged misconduct.
Advanced Imaging Specialists is as an independent, physician-owned radiology practice with an equal partnership model. It employs approximately 50-plus rads in 100% private practice covering multiple hospitals and 100% owned outpatient offices, according to a job listing with IndependentRadiology.com. The practice is currently hiring for overnights and weekends, among other needs, offering a salary range of $500,000 to $550,000 with additional compensation based on volume.
On the other side, Livonia, Michigan-based Trinity Health, which has over 90 hospitals across 25 states, has faced financial challenges in recent years. The health system said earlier this month it will lay off 10.5% of its revenue cycle management staff, outsourcing the work to a vendor. This as the Catholic nonprofit has grappled with low reimbursement from payers, increased costs for supplies, staffing shortages and federal funding cuts, Healthcare Dive reported. Trinity posted a $12.2 million operating loss on $25.4 billion in revenue during its fiscal year that ended June 30.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.