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The Big Picture
Managing Expectations
By Curtis Kauffman-Pickelle
 Editor Cheryl Proval and I had the privilege of moderating a very interesting and animated session at the recent RBMA meeting in New Orleans, Louisiana. It was a face-to-face panel discussion with the CEOs of each of the five radiology benefit management (RBM) companies. Anticipation built during the conference, and the attendees were definitely ready for their opportunity to grill these CEOs about what they view as the extremely burdensome processes of preauthorization, which have added costs and workload to their practices.
Each panelist was gracious and accommodating in responding to questions, and apart from a very few attendees who rather pointedly took issue with what the panelists had to say, the audience was respectful; it provided intelligent perspectives on the dilemma of how best to control rising costs in medical imaging.
Brandon Cady, CEO of American Imaging Management (Deerfield, Illinois); Curt Thorne, CEO of MedSolutions (Franklin, Tennessee); Cherrill Farnsworth, CEO of HealthHelp (Houston, Texas); Thomas Dehn, MD, CMO of National Imaging Associates (Avon, Connecticut); and Donald Ryan, CEO of CareCore National (Bluffton, South Carolina) fielded a variety of topics and questions that were designed to shed light on the business model, value proposition, processes, and role of RBMs in a health-care arena under extreme pressure to manage imaging utilization. Although they are competitors with each other, there was consensus among the five that the radiology managers had some very good points—chief among them, a suggestion that these five find ways to standardize their processes for the sake of efficiency in the imaging profession.
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Quality and Imaging: Be at the Table or on the Table
By Cat Vasko
This article is second in a four-part series on health-care reform and radiology. To read the first article in the series, click here.  
As specifics of how health-care reform’s provisions will be executed increasingly come into focus, the radiology industry awaits word on how it will be required to demonstrate quality under the new order. “By 2015, physician payments can be reduced by 1.5% if physicians are not reporting under the Physician Quality Reporting System (PQRS),” according to Ed Gaines, chief compliance officer for Medical Management Professionals, Inc (MMP), Atlanta, Georgia. He says, “We are moving from a pay-for-reporting to a pay-for-performance mentality and payment system.”
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Strategic MRI Acquisition Grows Volume: Imaging Healthcare Specialists
By Cat Vasko
 With 26 radiologists on staff and 11 locations in the San Diego, California, area, Imaging Healthcare Specialists (IHS) is the largest provider of outpatient imaging services in San Diego county; its reach extends into neighboring Riverside County as well. Like any busy radiology practice, IHS has a strong focus on MRI services, with 13 MRI systems spread over 10 locations. Glen Yoshitake, MRI manager for IHS, says, “We have seven high-field traditional 1.5T systems, a midfield open 0.7T system, and three low-field open 0.3T systems.”
Last year, IHS added two high-field Oasis 1.2T MRI systems (Hitachi Medical Systems America, Inc, Twinsburg, Ohio) to its armamentarium, one at its downtown San Diego imaging center and another in its Oceanside location. “Both were replacement systems,” Yoshitake says. “Adding them was part of an action plan of replacing older, lower-field scanners with newer systems that offer more clinical capabilities.”
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CT Coding Changes Impact 2011 Imaging-center Valuations
By Todd J. Sorensen, AVA
 Judging solely by the number of imaging engagements at our company during the first half of 2011, imaging transactions continue at a frantic pace. For the most part, there are not any new trends to report in imaging valuations. Discount rates, multiples, and the primary value drivers—competition, volumes, reimbursement, and capital-expenditure needs—remain the same. One change that has had a material impact on almost all multimodality imaging centers in 2011, however, is the change in coding for CT exams of the abdomen and pelvis.
In an ImagingBiz.com
article published earlier this year on radiology's reimbursement outlook for 2011, Cat Vasko of ImagingBiz.com and Randy Roat of Medical Management Professionals (MMP), Atlanta, Georgia, explored the impact of several key changes made to the Medicare Physician Fee Schedule (MPFS) for 2011
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Countdown to CMS Accreditation Nears Zero Hour
By Matthew Robb
 As the January 1, 2012, deadline nears for mandatory accreditation of advanced diagnostic imaging facilities, concerned ACR® officials have issued the equivalent of football’s two-minute warning, urging sidelined providers to mobilize and apply today. Government regulators have already reaffirmed their refusal to grant extensions, setting the stage for unaccredited facilities to lose potentially sizable Medicare reimbursement. Administrators should act now, rather than place their facilities in untenable situations.
Pam Wilcox, RN, MBA, the ACR’s assistant executive director of quality and safety, says, “We strongly urge nonhospital imaging facilities to start the online application process today. The January 1, 2012, deadline might be several months away, but the rigorous accreditation process—from online application to image review to final ACR approval—could take up to six months.”
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Storage Management and Planning in the EMR Era
By Cat Vasko
Health IT professionals have had their hands full in recent months, scrambling to understand how best to meet the provisions of meaningful use in order to capitalize on American Recovery and Reinvestment Act incentives—and, eventually, to avoid CMS payment penalties. One area affected by meaningful use that often goes unconsidered, however, is storage. “With the new meaningful-use requirements, widespread electronic medical record (EMR) adoption is going to generate even further demand on storage,” according to Frank Clark, PhD, vice president for IT and CIO at the Medical University of South Carolina (MUSC) in Charleston. “These changes will require a well–thought-out, well-defined strategy to meet the demands and needs that will be placed on storage.”
These new demands, Clark says, come on top of the demands already being placed on health-care organizations’ storage infrastructures by medical images—not only those gleaned from radiology and cardiology, but also those coming from dermatology, ophthalmology, and other specialty areas that are relative newcomers to generating image data. “Surgeons are also wanting to use more images from radiology and cardiology in their operating rooms,” he says. “That’s where the real growth and demand for storage currently is—across the different medical-imaging modalities.”
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The Radiologist’s Changing Role: A Q & A With Frank Seidelmann, DO
By Cat Vasko
 The radiology industry is undergoing tectonic changes as a result of declining reimbursements, ever-improving technology, and the emergence of innovative new delivery models. Though much has been written about the impact of these changes on the industry as a whole, the role of the radiologist in this evolving marketplace is often overlooked. Frank Seidelmann, DO, chair of the board and clinical director of neuroradiology at Radisphere National Radiology Group, Beachwood, Ohio, discusses with ImagingBiz how the role of the radiologist has evolved and predicts what today’s radiologists-in-training will seek from practices in the future.
ImagingBiz
: We’ve seen some rapid evolution in radiology delivery in the past couple of years. What forces are behind these changes in the industry?
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Meaningful Use, Artificial Intelligence Rank Among Top Imaging Informatics Trends
The top 10 trends in imaging informatics were the focus of a presentation at the opening session of the 2011 Society for Imaging Informatics in Medicine (SIIM) meeting. Such trends include the use of informatics tools to address radiation dose, radiology's participation in meaningful use, artificial intelligence applications in medicine, the growth of personal electronic health records (EHRs), increases in mobile technology usage, quantitative imaging, image sharing, workflow management, cloud computing, and business analytics/ data mining, said presenter Katherine Andriole, PhD, assistant director of imaging IT at Brigham and Womenâs Hospital, Boston, Mass.
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Increased Spending On Medical Services Improves Medicare Participants’ Health
More money spent on medical services for Medicare participants yields better overall health for these patients, reveals a new study from George Mason University and the Urban Institute. The results of the study will appear in an upcoming edition of Health Services Research, published by the Health Research and Educational Trust and an official journal of Academy Health. "The motivation for the study was a large body of research done over the past 10 years that typically has found that there is little or no relationship between how much Medicare spends and the health outcomes of elderly people," says Jack Hadley, PhD, a professor of health administration and policy at the university.
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FDA Sounds Breast Thermography Warning
Breast thermography should not be employed as a standalone screening tool independent of mammography for either breast screening or diagnosis, says the U.S. Food and Drug Administration (FDA). The FDA has cleared thermography—which utilizes infrared technology that shows patterns of heat and blood flow on or near the surface of the body—for use in conjunction with mammography as an additional tool for breast cancer screening and diagnosis. However, it is being touted by certain health care providers as an effective means of detecting breast cancer when used alone, the FDA says. Some of these providers, the agency states, have posted inappropriate clinical claims pertaining to thermography on their Web sites.
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RBM Benefits Unclear, Researchers Say
While the six largest radiology benefits management firms (RBMs) cover an estimated 88 million privately insured Americans, there still exists only limited information to trumpet their cost-effectiveness or positive impact on patient care, according to a study published in the June issue of the Journal of the American College of Radiology. "Our analysis demonstrated that RBMs have the potential to either increase or decrease societal costs under a range of plausible assumptions about the parameters that govern their economic impact," the authors write. "This cost shifting creates scenarios in which RBMs are cost saving from the perspective of a health plan but actually increase costs to the healthcare system overall."
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JUNE
ANI: The Healthcare Finance Conference
Sponsored by the HFMA
June 26-29
Gaylord Palms Resort and Convention Center
Orlando, Florida
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AUGUST
AHRA 2011 Annual Meeting and Exposition
Sponsored by AHRA: The Association for Medical Imaging Management
August 14–17
Gaylord Texan Grapevine, Texas
Register >>
OCTOBER
2011 RBMA Fall Educational Conference
Sponsored by the RBMA
October 16–19
Aria Resort and Casino Las Vegas, Nevada
Register >>
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