|
The Big Picture
Bursting the Radiology Bubble
By Curtis Kauffman-Pickelle
 I have written frequently about the implications of economic turbulence in radiology; we are facing some now, and others will unfold in the months and years ahead. These far-reaching implications concern nothing less than the survival of some private radiology practices and the death of fee-for-service payment. Our current economic model is obviously unsustainable: Society can’t afford it, and payors are tired of feeding this dysfunctional beast.
Key to understanding how anticipated changes in payment will profoundly affect the profession three to five years from now is the notion that ours is a marketplace in which supply and demand are unbalanced—in favor of payors. This gives buyers confidence that continuing to squeeze costs out of imaging will not result in denied access. The wait for a study might become longer, but excess imaging capacity indicates that such delays will be minimal.
Click here for more | Return to TOC
|
|
|
More Than Money Is on the Line As Meaningful Use Matures
By Cat Vasko
 In early May, the ACR® submitted comments to CMS and the Office of the National Coordinator (ONC) for Health IT on the proposed rules¹ for stage 2 of the meaningful-use incentive program. The proposal from the federal agencies, released March 7, is much more inclusive of radiology than the rules for stage 1 were, with new objectives that include making imaging results and information accessible through certified electronic health record (EHR) technology. In its comments, the ACR applauds the ONC and CMS for pushing for this level of access, while recommending that the ONC familiarize itself further with the Web Access to DICOM Persistent Objects part of the
DICOM standard.
Vijay Ramanathan, president and CEO of RamSoft Inc, notes that adherence to standards is much more than a component of the meaningful-use program: It is the program’s overall goal. “The one real, solid objective of meaningful use is to establish certain common standards for all health-care software,” he says. “By establishing these common standards, with each future stage of the program, they’re going to increase the ease of communication between different systems. With strict standardization and certification, we could end up with a plug-and-play environment.”
Click here for more | Return to TOC
|
|
Upgrading CT in the Emergency Department: Columbia Memorial Hospital Case Study
By Cat Vasko
In August 2011, Columbia Memorial Hospital (Hudson, New York) began the process of selecting a new CT system to replace the four-slice system that the organization had been using in its emergency department. As Rhonda Makoske, director of medical imaging, explains, the 192-bed acute-care hospital is a local stroke center; two 64-slice CT systems are used for outpatient imaging, while the emergency-department system does double duty and is used for inpatient imaging as well.
“We were replacing 10–year-old technology,” Makoske recalls. “We went through a lengthy selection process, looking at four different vendors—and through site visits, image evaluation by the radiologists, and speaking to users of the systems, we were able to create a spreadsheet with all of the attributes of the different vendors’ systems listed.”
Click here for more | Return to TOC
|
|
Radiology Practice Partners With Genetic Counselors on Cancer Risk
By Cat Vasko
 At the 22nd Annual National Interdisciplinary Breast Center Conference in Las Vegas, Nevada, Ellen Nipe, Sherrill Little, MD, and colleagues presented the poster session “Systematic Risk Assessment in a Large Imaging Center” on March 13, 2012, reporting the results of an experiment at Booth Radiology (Woodbury, New Jersey). The practice currently offers cancer-risk assessment, in the form of genetic counseling, for its breast-cancer–screening patients, and the poster session covered results garnered from October through December 2011.
Little, a radiologist at the practice, says, “We wanted to provide full-service women’s health care. A lot of these women are at a significantly increased risk of cancer and either don’t know it or have never been evaluated.” In fact, research¹ indicates that only 19% of physicians who ordered a BRCA1/2 test for patients correctly identified low- and high-risk scenarios; in a survey², 90% of physicians believed genetics were important to their practice, but fewer than 25% felt comfortable discussing genetic-testing results with patients.
Click here for more | Return to TOC
|
|
Launching the MSO: Inside the Genesis of Canopy Partners
By Cat Vasko
  In January 2011, Canopy Partners, a management-services organization (MSO), officially spun off from Greensboro Radiology in North Carolina. The large practice had been providing business, IT, and other nonclinical services to some of its partners and was working to diversify its offerings further. Worth Saunders, MHA, CEO of Canopy Partners, says, “We had a pretty good base of business under the Greensboro Radiology umbrella in IT expertise,
PACS, voice recognition, workflow integration, and other solutions. We saw a great need to expand those offerings and thought a separate brand with an independent structure and governance would enable that growth.”
Stephen Willis, CIO of Canopy Partners, explains that the newly formed MSO saw a particularly promising opportunity in the need for IT customization. “We understand, from a physician’s perspective, what the difference is between an integrated product and a well-integrated product,” he notes. “We see examples of integration that are theoretically integrated, but cumbersome for physicians to use. We do things in a unique way and integrate to a level we don’t typically see in this industry. It’s our goal for the technology to serve the individual, not the other way around.”
Click here for more | Return to TOC
|
|
Smart Growth: Outpatient Imaging in the Age of Reform
By Cat Vasko
According to a 2011 report¹ developed by Radiology Business Journal with data from SDI (formerly Verispan), while imaging-center chains in the United States experienced a slower rate of growth in 2011 than in previous years, the total number of imaging centers in the country increased by 72, for a total of 6,383. At a time when radiology-group alignment with hospitals and health systems is making headlines as a trend, freestanding imaging continues to be strong in many markets.
  On May 10 at the Health Connect Partners Radiology & Imaging Conference 2012, held in Miami, Florida, three large imaging-center companies presented their strategies for building an outpatient imaging presence amid some of the changes that have affected the radiology market in recent years in a session entitled “Freestanding or Hospital-based Imaging: Are You in the Right Game?” Among their representatives was Creighton Cook,
director of business development for Outpatient Imaging Affiliates (OIA), who notes that his company is bullish about the future: “There is no reason to believe freestanding imaging centers won’t be a viable option for years to come,” he says.
Click here for more | Return to TOC
|
|
Investing in Radiology IT: The Practice Perspective
By Cat Vasko
This article is the second in a four-part series. To read the first article, click here.
 Radiology practices trying to prioritize their IT investments must consider the needs of multiple constituencies in order to make smart decisions. While the needs of referrers—and increasingly, patients—are important, the practice must also look at its own internal technology needs to make investments that serve its strategic goals. In today’s radiology market, that technology must provide the practice with an on-demand snapshot of its performance and enable it to benchmark that performance against itself and against similar practices to establish targets, according to Neal Peterson, director of client development for Medical Management Professionals (MMP).
“When radiology groups were making money hand over fist and could not lose, no matter what, decision making was a looser process,” Peterson says. “The climate, especially the downward pressure on reimbursement, is the reason that practice technology is so much more important now. All the radiologists want the practice to have this technology, and they want to have access to it.”
Click here for more | Return to TOC
|
|
Member of the following organizations:
|
Cancer Risk Increases After Childhood CT: Lancet Study
In a joint study of the long-term health outcomes of pediatric cancer patients dating back as far as 1985, radiation from diagnostic imaging scans nearly tripled children’s risks for leukemia and brain tumors, according to a study published in The Lancet. Even excluding from its assessment CT studies that were conducted as a course of cancer treatment, researchers observed an increased risk for cancers in their follow-up. Given these findings of associated risk, researchers are advocating for the use of alternative diagnostic methods that include non-ionizing radiation whenever possible in dealing with pediatric populations.
Read More >>
House Passes Medical Device Tax Repeal
On June 7, the U.S. House of Representatives passed H.R. 436, the Protect Medical Innovation Act of 2011, which would repeal a 2.3% tax on the sale and importation of medical devices in the United States. The tax, which is scheduled to take effect in 2013, would provide an estimated $29 billion in federal revenues through 2022. Sister legislation to repeal the tax is not expected to survive a Senate vote; moreover, according to Bloomberg Businessweek, the White House “would recommend a veto” if it did. To make up the difference in revenues, H.R. 436 would require people who participate in flexible health savings accounts to obtain prescriptions for over-the-counter medications and to then use those dollars to pay for them.
Read More >>
CT Procedures Up, Growth Slowing: IMV Report
Although the number of CT procedures performed across the country is still increasing annually, a new survey from market researchers IMV shows that the days of double-digit growth are behind the industry. According to IMV, more than half of all sites in its study (58 percent) expect that their throughput will increase in 2012, and another one-third (34 percent) anticipate that procedures this year will at least match 2011 output. Impediments to growth cited in the report include fewer reimbursement dollars despite flat or increasing patient volumes and an uptick in the number of ER patients requiring CT procedures.
Read More >>
Radiologist Challenges Certificate of Need Law
A Maryland radiologist is challenging Virginia certificate-of-need laws in federal court, saying that the laws requiring him to demonstrate a patient demand for his services prior to opening a new imaging center are outdated and anti-competitive. Mark Monteferrante, MD, filed his suit with the aid of the libertarian public interest law firm, the Institute for Justice. In the past two years, the Associated Press reports, only 15 to 20% of CON applicants in the state have been rejected; however, Monteferrante says that the cost and paperwork are too prohibitive. His suit claims that Inova Health Systems, a division of which bought out his first Virginia clinic, holds an iron grip on the region.
Read More >>
|
JUNE
International Symposium on Multidetector Row CT
Sponsored by the International Society for Computed Tomography
June 17–20
Hyatt Regency
San Francisco, California
Register >>
AUGUST
AHRA 2012 Annual Meeting and Exposition
Sponsored by the AHRA
August 12–15
Gaylord Palms
Orlando, Florida
Register >>
OCTOBER
2012 RBMA Fall Educational Conference
Sponsored by the RBMA
October 7–10
Sheraton Wild Horse Pass Resort
Chandler, Arizona
Register >>
Economics of Diagnostic Imaging 2012
Sponsored by ESI Educational Symposia
October 24–28
The Ritz-Carlton, Pentagon City
Arlington, Virginia
Register >>
|
Subscribe now to radiology's next-generation economics journal
Coming in the June/July Issue
[Click here]
|
