William Barta

It’s no surprise that so many provider organizations threw their weight behind the recently passed health-reform bill. In 2009, 72% of hospitals reported increases in uncompensated care.¹ The vast majority also reported decreases in both elective procedures and inpatient admissions, difficulty acquiring capital, and moratoria on capital projects (both planned and started).¹ Clearly, the economic downturn has disproven the old adage: Health care is not recession proof.

Such stringencies have led to renewed scrutiny of costs, yielding encouraging results for one hospital system. William Barta, corporate imaging director, Fairview Health Services, Minneapolis, Minnesota, reports that in the past 18 months, the system has increased its operating margin fourfold, from 1% to 4%, in spite of the downturn. He described recent and ongoing cost-containment efforts in the radiology service line that are going straight to the bottom line.

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As the deadline inches closer, radiology providers around the country are scrambling to meet new CMS accreditation requirements for MRI, CT, and nuclear medicine. By mandate of the Medicare Improvements for Patients and Providers Act (MIPPA), in order to receive Medicare reimbursement for these modalities, imaging centers must be accredited by the Joint Commission, the ACR®, or the Intersocietal Accreditation Commission (IAC) on January 1, 2012.

Tammie Sloper, director of marketing for the IAC, says, "We are recommending that they get started right away. One of our greatest concerns with MIPPA is that the law stipulates that they are actually accredited on January 1; some of the facilities are more familiar with private-payor policies, which are based on submission, rather than accreditation."

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While the industry landscape has certainly changed significantly since Radiology Business Journal published my article on this subject three years ago, the primary factors that drive the desire to complete transactions and the valuations remain largely intact.

There does, however, seem to be a different reaction to the latest dose of seismic change in the health-care industry. What we observed in the months leading up to and following the passage of the DRA in 2006 was a sort of paralysis in the market. Sellers were not willing to sell at valuations that reflected all, or maybe even any, of the changes in reimbursement resulting from the implementation of the DRA. On the other hand, buyers were not willing to buy at valuations that did not fully reflect changes in reimbursement.

Perhaps the relatively recent nature of the experiences of buyers and sellers through the DRA episode is providing the parties with some confidence to press on through the current episode of change.

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Steven Horii, MD

In February, the FDA announced a new initiative to reduce unnecessary radiation exposure from CT, nuclear-medicine, and fluoroscopy exams. The agency’s three-pronged approach will include issuing safeguard requirements for device manufacturers, incorporating quality-assurance measures in mandatory CMS accreditation for imagers, and creating national dose registries to aid in the development of diagnostic-radiation reference levels.

For imaging centers and hospitals, the renewed focus on radiation creates a conundrum: How can cumulative dose be efficiently and effectively tracked?

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