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The Big Picture
Predator or Prey?
By Curtis Kauffman-Pickelle
 Here we go again: In a replay of the early, heady days when HMOs and managed-care models blurred the lines between payor and provider, we are again seeing health-care consolidation on a dizzying scale—which is almost obliterating that line completely. Two recent deals are emblematic of both the movement toward integrating into new models of care and the scramble for just who and what will define what it means to be an accountable-care organization (ACO).
Highmark Blue Cross Blue Shield (Pittsburgh, Pennsylvania) announced a deal to acquire the second-largest hospital chain in the region, the five-hospital West Penn Allegheny Health System (Pittsburgh), for $475 million.¹ In a hint that this is likely to be a trend with many dimensions, Highmark indicated in the article that it might buy or invest in other providers, including physician practices.
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Joint Adventure: A Case Study in Hospital–Practice Integration
By George Wiley
This article is the second in a four-part series on options for hospital–practice integration. To read the first article, click here.  
Of one of the largest joint-venture integrations ever completed between a hospital and a radiology group, Robert Maier, CPA, CEO of Regents Health Resources, Inc, a consultancy headquartered in Franklin, Tennessee, notes, "It's not often that you get to the end of a transaction and both parties feel really good, but here, the benefits and contributions have all worked to success, and both parties are pleased." The transaction to which Maier refers wasn't completed overnight. It took two years—but when it was completed, and the finished entity began operation on April 1, 2011, a $100 million joint venture between a Nashville hospital system and a prominent Nashville radiology practice stood as a monument to perseverance.
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Improving Radiology for Radiologists: Thomas Pope, MD
By Cat Vasko
 Thomas Pope, MD, a musculoskeletal MRI and breast-imaging specialist with Radisphere National Radiology Group (Beachwood, Ohio), began his career in subspecialty imaging before it was common for radiologists to be fellowship trained. “I never did a fellowship, but I received on-the-job training in musculoskeletal radiology from my mentor at the University of Virginia,” he recalls. Later, when the university opened a primary-care facility with a focus on providing breast imaging, Pope became its director of imaging. “It was part of the job, so I got into that specialty area as well,” he says.
That was in the early 1980s; 30 years later, Pope believes that the radiology industry has fallen behind on subspecialization, at least in the private-practice environment. “In academic radiology, there has been subspecialization over the past 15 to 20 years, so it isn’t as big of an issue,” he says, “but in private practice, the rule is you have to read everything. Because you have to take call, you have to be a generalist, to a certain degree. I don’t know how we’ve gotten away with not subspecializing before now.”
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ACOs and Radiology Technology: A Conversation With Bibb Allen Jr, MD
By Julie Ritzer Ross
 The Patient Protection and Affordable Care Act calls for early adopters to launch accountable-care organization (ACO) demonstration projects and shared-savings programs in 2012. The development of these value-added services and the general trend toward formation of ACOs will undoubtedly lead to changes not only in the acquisition of imaging technology by providers, but also in the radiology landscape as a whole.
Bibb Allen Jr, MD, of Trinity Medical Center in Birmingham, Alabama, says, “We are on the cusp of some major shifts.” ImagingBiz.com sat down with Allen (who is chair of the ACR Commission on Economics and served as lead author of an article,1 “ACR White Paper: Strategies for Radiologists in the Era of Health Care Reform and Accountable Care Organizations: A Report From the ACR Future Trends Committee,” that recently appeared in Journal of the American College of Radiology: JACR) to discuss these changes.
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Managing the Email Archive: Compliance and Complexities
By Cat Vasko
Health-care IT professionals are no strangers to the complexities that arise from managing ever-growing archives. One particular subset of the data stored across the enterprise, however, might be overlooked: email archives. Although one analysis by Enterprise Strategy Group (ESG), Milford, Massachusetts—a market-research and analyst company—suggests that between 2007 and 2009, the average organization’s email archive grew between 200% and 300%, many health-care organizations still use a traditional archive to manage retention of older email messages.
Brian Babineau, vice president of research and analyst services at ESG, says, “We’re subject to regulatory requirements that call for certain content to be subject to record retention, and a portion of that content may reside or be communicated via email. We archive because we have to archive.”
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Better Business Intelligence: Enhanced CPT Code Analysis
By Cat Vasko
This article is the first in a two-part series about how radiology practices can derive superior business intelligence from their existing coding and payment data.  
Historically, radiology practices have looked at CPT® code volume as a measure of work. As Greg Thomson, CPA, executive vice president of Medical Management Professionals, Inc (MMP), Atlanta, Georgia, explains, “It is the widget we have used to measure the work performed by our physician clients, and also a measure of the work performed in the billing office.” Thomson and his colleague Jana Landreth, CPA, MBA, would argue, however, that there are better ways to measure physician work—and that practices are often neglecting to pursue the full range of business intelligence available from analysis of these kinds of data.
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Blood Pool Agent Offers Promise For Imaging
BR38, a new microbubble-based blood pool agent for contrast-enhanced ultrasound imaging, offers promise for non-cardiac and cardiac applications, including myocardial perfusion imaging, according to a study in the August issue of Investigative Radiology.
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PACS Integration Fosters Use of Decision Support Tools
The ability to access online decision support solutions from within a PACS environment increases radiologists’ use of these tools, reveals a study in the July issue of the Journal of the American College of Radiology. However, integrated access must be provided upon system deployment rather than down the road.
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Specialists Will Benefit From State Health Insurance Exchanges, Study Says
The creation of state health insurance exchanges under new rules released this week by the U.S. Department of Health and Human Services (HHS) will likely prove a boon to radiologists.
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ACR Voices Objections to Breast Cancer Screening Guidelines
Following breast cancer screening guidelines suggested in a study published in the July 5, 2011 issue of Annals of Internal Medicine may negate "the significant, and proven life-saving benefit of mammography in women ages 40 and over and result in thousands of unnecessary breast cancer deaths each year," according to the American College of Radiology.
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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 >>
SEPTEMBER
Webinar: Developing a Comprehensive IT Strategy for the Practice
Save the Date: September 13
Mark Alfonso, MD, President, Riverside Radiology
Marcia Flaherty, CEO, Riverside Radiology
Ron Hosenfeld, CIO, Riverside Radiology
Jim Morgan, VP, Medical Informatics, Fujifilm Medical Systems, USA
OCTOBER
2011 RBMA Fall Educational Conference
Sponsored by the RBMA
October 16–19
Aria Resort and Casino
Las Vegas, Nevada
Register >>
2011 Community Hospital Executive Management Conference
Sponsored by Community Hospital 100
October 23–25
Pinehurst Resort
Pinehurst, North Carolina
Register >>
Economics of Diagnostic Imaging 2011
Sponsored by ESI Educational Symposia
October 27–30
The Ritz-Carlton Pentagon City
Arlington, Virginia
Register >>
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