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The Big Picture
Can You Compete With South Korea?
By Curtis Kauffman-Pickelle
 There is no question that the competitive environment for medical-imaging services has become much more intense in recent years. As prices erode and certain commoditization sets in, branding, messaging, and the ability to differentiate a value proposition are becoming critically important to the success of hospitals, imaging centers, and practices. Basic principles of competition indicate that if you don’t take the time to brand yourself, your competition will do it for you, and you will not like their idea of your value.
If it is your view that this is among those squishy and soft issues in today’s delivery of high-quality imaging services that you would just rather not deal with, you are not going to be happy that the stakes have been raised yet again. If you are not already ahead of the curve in terms of developing a top-level marketing footprint, you will probably be surprised to learn that in the future, you just might be asked to compete with an imaging practice in Singapore or South Korea.
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Service and Support Are Critical to PACS Success
By Cat Vasko
 Like many radiology practices in the United States, Premier Radiology (Nashville, Tennessee) has seen its share of changes over the past few years. James C. King, MD, radiologist and owner, says, “It’s been a tumultuous time. Six years ago, we had one outpatient center; now, we have nine. We provide teleradiology from Maine to Washington state, and on April 1, 2011, we entered into a joint venture with one of the large hospital chains in Nashville.”
The growth spurt and joint venture alike were the result of an analysis of the current economic environment for radiology; as practice leaders projected five years into the future, King says, “We were thinking we really needed some kind of a hospital partner.” The result was a joint-venture arrangement with the local Ascension Health system, which resulted in Premier Radiology’s 32 radiologists reading for five hospitals, in addition to its outpatient imaging centers and teleradiology clients.
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Mergers and Acquisitions: Putting a Price on Reputation
By Greg Thompson
 The concept of personal goodwill in the mergers and acquisitions of imaging centers occupies a decidedly intangible realm. John P. Holman, JD, an attorney in the Falls Church, Virginia, office of law firm Reed Smith LLP, has seen negotiations play out largely over the goodwill issue, with patience and persistence sometimes winning.
Holman recalls negotiations for groups that owned profitable imaging centers where significant value was added by negotiating a price far in excess of just the fair market values of the tangible assets and receivables. Even better results have been obtained where the buyer was convinced that a large portion of the extra value was attributable to the personal goodwill of the owner physicians.
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The Business Case for Pediatric Imaging: Kids’ MRI at Lourdes Hospital
By Cat Vasko
Lourdes Hospital in Binghamton, New York, knew that it was losing pediatric MRI patients to a local imaging center with a 0.6T open MRI system, but it wasn’t until the imaging department started collecting data and tracking how many phone calls a day it received inquiring about open MRI that it decided to install an open system alongside its 1.5T conventional closed-bore scanner.
“We were getting four or five calls a day for the open architecture,” Brian Wetzel, director of diagnostic imaging at Lourdes Hospital, recalls. “We started evaluating the equipment out there, looking for a system that would provide that open architecture with state-of-the-art images.”
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Outsourced Billing: An Administrator’s View
By David Myrice, CPA, MBA
 The decision to outsource a radiology practice’s billing can be emotionally fraught. Many practices have historically employed sizable in-house billing departments, and though the decision to outsource might appear simple from an economic perspective, when it comes to putting people out of work, administrators understandably blanch. Further, while the decision to outsource is not completely irreversible, it will be difficult for the practice to reinstate in-house staff members after letting them go.
For this reason, when attempting to determine whether outsourcing billing is the right move for a practice, it is useful to consider multiple factors before making a final call. While outsourcing is almost always the more affordable option, the decision must be more nuanced than just comparing cost estimates to see which would be lower.
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Imaging in the Global Marketplace: A Conversation With Stephen Pomeranz, MD
By Cat Vasko
 As radiology practices continue to grow in size via mergers, partnerships, and other forms of consolidation, the model of the nationwide practice is beginning to appeal to many. ProScan Imaging (Cincinnati, Ohio) owns 24 freestanding imaging centers in the United States, and it offers teleradiology services both nationally and internationally. ImagingBiz spoke with Stephen Pomeranz, MD, ProScan’s founder and CEO, about the practice’s business model and how it reflects a changing radiology marketplace.
ImagingBiz: ProScan has a wide national and international reach. Can you characterize the company’s business model?
Pomeranz: The foundation of our business model is the quality of our people, including internal staff, business partners and customers. Everything is focused on making physicians—especially radiologists—successful, so we focus on using quality education and service to raise the bar of care for people, regardless of country or nationality. We train all members of our customer service and radiology teams to function at the highest level. What we do externally, we also do internally, which is treat our employees and customers with the utmost respect and work hard at raising their level of expertise, and many of them stay for that very reason. We create our own internal culture of excellence.
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Virginia, Utah Join States Considering Breast Density Notice Laws
A growing number of states are considering new laws that require radiologists to notify women of their breast tissue density as part of a routine mammogram. Connecticut became the first state in 2009 to pass a law that urges women with dense breast tissue to consider additional screening such as ultrasound or MRI. Bills are currently being considered in Utah, Virginia, New York, New Hampshire, New Jersey, Pennsylvania, Tennessee, Kansas, Missouri and Nebraska, and legislators in several other states are in the drafting stages.
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Lawmakers Deadlocked on Doc Fix
Congressional lawmakers are reportedly at an impasse over how to pay for a one-year Medicare “doc fix” along with extension of the payroll tax cut and unemployment benefits. A proposal by the American Medical Association to use war savings to pay for a freeze on physician payments under Medicare has reportedly died. According to several reports, both parties are committed to freezing physician pay under Medicare until December; the only question is how to pay for it. Without an agreement, physicians stand to lose an average 27.4% in reimbursement based on the Sustainable Growth Rate formula.
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PA Supreme Court Grants Emotional Distress Without Physical Negligence
The Pennsylvania Supreme Court issued a recent ruling that said a physician could be held liable for emotional distress even if there was no physical negligence to the person being harmed. The case involved a mother who says her physician, a radiologist, failed to prepare her for the emotional distress of delivering a baby with physical deformities. The mother had received an ultrasound prior to giving birth in which she was told the baby was healthy. The case is said to open the door for similar lawsuits against physicians for non-economic damages.
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Medical Imaging Groups Convene to Ease PET Restrictions Under Medicare
The Medical Imaging and Technology Alliance plans to make formal recommendations to CMS asking the agency to reconsider its exclusionary coverage of PET and PET/CT. The group identified five proposals that will soon be narrowed down to formal recommendations to CMS; they called for making the noncoverage determination process more nimble; for the Food and Drug Administration to conduct a parallel review along with CMS; or for CMS to grant immediate coverage, subject to further review, for PET and PET/CT to diagnose and monitor a wide range of cancers.
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FEBRUARY
HIMSS 12 Annual Conference and Exhibit
Sponsored by the Healthcare Information and Management Systems Society
February 20–24, 2012
Venetian Sands Expo Center
Las Vegas, Nevada
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MARCH
Building Better Radiology Marketing Programs
Sponsored by the RBMA
March 18–20, 2012
Westin Fort Lauderdale
Fort Lauderdale, Florida
Register >>
Congress on Healthcare Leadership
Sponsored by the American College of Healthcare Executives
March 19–22
Hyatt Regency Chicago
Chicago, Illinois
Register >>
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