The Industrial-strength Imaging Executive
by Curtis Kauffman-Pickelle
Today’s medical-imaging profession is definitely not for the fragile and weak-kneed among our colleagues. It is becoming increasingly clear that navigating the constant changes and challenges that face the practice of radiology today will be the ultimate test of tenacity, perseverance, and creativity. We’re in the playoffs now, and the game is moving to the big-time arena—where the margin for error is nil.
Finger in the Wind
by Cheryl Proval
Physicians are in a real bind as fee-for-service reimbursement falls under attack and alternative payment methods (such as bundling and capitation) gain traction in Washington, DC. As of June 18, Medicare Part B claims were being processed with the 21.3% cut mandated by the sustainable growth rate’s formula, and House Democrats demanded legislation on jobs before they would pass the Senate bill to reverse the cut.
Consulting and Marketing Services
We provide strategic business and marketing expertise to assist in the growth of your medical imaging enterprise.
Our clients include radiology practices, imaging centers, and hospitals in large and small markets across the country.
Save the Date:
July 20, 2010 11am ESTTopic
Keep Your Hospital Relationships Healthy: Strategies for Every Practice
Presenters:
Randy Roat, CHBME, VP of Radiology, MMP, and George Ehrhardt, CPA, Director, Practice Management, MMP
Medical Management Professionals, Inc.
Topic
RIS to the Rescue | Strategies for Driving Revenue, Productivity and Profitability
Sectra
Topic
Advanced Visualization | Next-generation Architectures
Visage Imaging
Fail-safe: Automating Critical-results Notification
The radiology department at Brigham and Women’s Hospital (BWH), Boston, Massachusetts, created a policy for communicating critical and discrepant results after the Joint Commission made communications among caregivers a national priority for health-care providers. When the goal was expanded in 2007, the department took the next step and used IT to automate the process and to embed it into radiologist and referring-physician workflow.
The Industrial-strength Imaging Executive
Today’s medical-imaging profession is definitely not for the fragile and weak-kneed among our colleagues. It is becoming increasingly clear that navigating the constant changes and challenges that face the practice of radiology today will be the ultimate test of tenacity, perseverance, and creativity. We’re in the playoffs now, and the game is moving to the big-time arena—where the margin for error is nil.
Succession Planning for Health-care Organizations
According to a 2004 study by the American College of Healthcare Executives, only 21% of 722 hospitals routinely engaged in leadership-succession planning, compared with two out of three for-profit companies in other industries.
The Message Is the Medium
As a journalism and media student in the early 1970s, I was exposed to what was just then emerging as an entirely new way of aligning the creators of information with those who were hungry to receive it.
Studies Support Error Theory
Much of the evidence said to support the theory that radiology subspecialists make fewer mistakes than their generalist colleagues is anecdotal.
Subspecialty Radiology: Beyond the Debate
While debate continues to swirl around the future of general radiology, the marketplace is clearly moving toward subspecialization and the real-world challenges that it presents.
From Partner to Employee: The Captive Radiology Practice
The hospital-employed model and the proliferation of corporate teleradiology providers are causing more radiologists to choose employment over partnership.
Pat Basu, MD, MBA: The Radiologist in the White House
While radiologists have served in prominent positions in Washington, DC, in the past, none have ever served as White House fellow and special assistant to the president before the recent appointment of Pat Basu, MD, MBA, as one of 13 men and women to serve in the 2010–2011 class of fellows.
Mindful Cost Cutting
Consider this scenario: You have exercised your duties as a manager over the past several years by cutting costs where possible, but now, you have been ordered to make further administrative cost reductions of 10%, 20%, or even 30%, and you cannot fathom how it will be done. Does this sound familiar?
Effective Quality Assurance: Obstacles and Pointers
As the radiology marketplace matures, becoming increasingly competitive, it’s more important than ever for practices to differentiate themselves based on quality, according to Peter Franklin, MD, chair of radiology for Radisphere National Radiology Group, Cleveland, Ohio.
Scenario Planning for Health-care Organizations
If you’re not scenario planning, you’re not planning. This bold assertion, issued in a recent white paper by GE Healthcare, is the driving philosophy behind the company’s $6 billion healthymagination initiative, and is an approach that it hopes to spread among health-care organizations.
Radiology’s New Normal
Don’t think that you are alone if the current uncertainty in virtually all aspects of medical imaging is driving you to distraction. Today’s radiology marketplace/profession has become increasingly complex, hypercompetitive, and extremely tense; the traditional relationships are in a constant state of flux.
ACR Unveils Breast MRI Accreditation Program
To enable imaging facilities to improve and maintain the quality of their breast MRI services, the ACR® has launched the Breast Magnetic Resonance Imaging Accreditation Program (BMRAP).
The Tortoise and the Stack Burner
It is all too common for practices to devalue organization building in the race to productivity
CEO Roundtable: Practice–Hospital Relations
Independent radiology practices grapple with declining technical fees, commoditization threats, and the hospital interest in captive practices, as practice CEOs face unprecedented challenges
How Hospitals Are Rethinking Imaging
Economic and market forces are prompting hospitals in two Ascension Health hospital systems to reengineer the delivery of imaging
Strategic Radiology: 15 Practices Align for Strength
A new, radiologist-owned corporation is taking tentative, careful steps toward a national practice
Life After Sutter
When news spread that Sutter Health (Sacramento, California) planned to cut loose its long-time radiology provider in Sacramento in favor of a captive model, some observers wondered how Radiological Associates of Sacramento (RAS), a 76-radiologist practice founded in 1917, would survive.
The Problem With Physicians Like Him
Author Thomas H. Lee, MD, writes that the problem with medicine is people like him: primarily men, in their 50s and beyond, who learned medicine when it was more about art and less about money.
Tracking Patient Radiation Dose: IT Implications
In February, the FDA announced a new initiative to reduce unnecessary radiation exposure from CT, nuclear-medicine, and fluoroscopy exams.
Leading an HCO in an Era of Scarce Resources: Implications for Radiology
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
Tapping the Rural Market: A User’s Guide
The emergence of PACS has given practices a chance to expand their business and boost revenue by tapping the rural hospital market.
The Tortoise and the Stack Burner
You know the tale. In the end, the steady pace of the tortoise won out over the supreme confidence and sheer speed of the hare; the hare simply did not value the focus, commitment, skill set, and tenacity exhibited by the tortoise.
Teleradiology Providers Open the Door to Cost Savings
Community hospitals, like their larger counterparts, continue to encounter financial challenges as they strive to deliver cutting-edge imaging services.
Deadline 2012: MRI Accreditation
Under the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, those sites providing the technical component of advanced imaging must have accreditation by 2012—but not all imaging centers are waiting for the deadline.
Business 101: Using Basics to Grow Revenue
As imaging centers nationwide look for new revenue streams to compensate for ever-declining reimbursement, the answer might be getting back to basics, according to Greg Thomson and Dan Simile Jr of Medical Management Professionals, Inc (MMP), Atlanta, Georgia.
Radiology’s Next Move
Imagine the situation facing radiology practices and their changing market relationships as multiple, concurrent chess matches.
An Urgent Case for Quality
Gary Becker, MD, outgoing president of the RSNA, read members the equivalent of the riot act in his presidential address on November 29 in Chicago, Illinois, kicking off the 2009 meeting and jump-starting the quality-improvement movement in radiology.
Relationships Gone Wild
All across the country, we are seeing the dissolution of long-time hospital–practice relationships that are part of the community fabric
Radiology Practices Fight Declining Technical Revenues
Declining technical revenues have become a way of life for imaging practices.
Restructuring: The Way JVs Get Done
After Congress passed the DRA, reducing Medicare reimbursements for imaging services, the radiology landscape has never been the same.
Engaging Physicians in Hospital Radiology Quality Initiatives
The question of how to engage physicians in hospital quality initiatives “is one that many organizations are grappling with,” according to Albert Bothe, MD, chief quality officer for Geisinger Health System, Danville, Pennsylvania.
The Quest for Quality in Radiology
With Quality Counts as its theme for 2009, the RSNA’s 95th Scientific Assembly and Annual Meeting in Chicago, Illinois, obviously emphasized multiple aspects of quality assurance, control, and improvement.
Key Metrics for 2010: A Conversation With Marcia Flaherty, CEO, Riverside Radiology
At RSNA 2009, analysis of key metrics was emphasized as a means for radiology practices to improve operations, augment quality, and reduce costs.
CT Radiation Dose on the Table
Long a point of concern in Europe, radiation dose has emerged as a key point of consideration for pediatric radiologists in the United States, particularly with the development of multidetector CT.
A Time for Introspection
The question that I am most often asked is why I remain so confident and bullish about radiology’s future, given all of the bad news that continues to drain our collective will.
Informatics: Linchpin of Personalized Medicine
In urging radiologists to adopt a new focus on quality improvement, RSNA outgoing president Gary Becker, MD, outlines the steps necessary to achieve this goal and calls informatics integral to the process.
Jeff Bauer, PhD, on Transforming Health Care
Health care futurist and consultant Jeff Bauer, PhD, coauthor of the book Paradox and Imperatives in Health Care: How Efficiency, Effectiveness, and E-Transformation Can Conquer Waste and Optimize Quality
All Eyes on Accreditation
In July 2008, Congress passed the Medicare Improvements for Patients and Providers Act (MIPPA)
Leveraging RVU Data to Improve Productivity
Friendly competition has developed among the five radiologists of Capital Imaging Associates, Albany, New York, to the benefit of referrers (and, potentially, to patient care).
Scanning Imaging’s Deals
With no stimulus package in the wings, the future belongs to those leaders in radiology who dare to innovate
Good Governance
Today’s successful radiology practice implements effective governance structures and decision-making methods
A Cure for the Decision-making Disorder
Five centuries ago, the Roman Catholic Church introduced the devil’s advocate for the express purpose of countering arguments in favor of canonization.
Evaluating Radiology’s New Revenue Streams
In January 2008, the ACR® appointed a task force to research and report on the efficacy of the increasing number of value-added services in radiology.
Quality Control With A Custom Fit
Less than a year ago, the radiology department at the Fletcher Allen Medical Center (FAMC), Burlington, Vermont, the hospital affiliate of the University of Vermont College of Medicine, was struggling with antiquated peer-review and quality-control (QC) methods.
Scanning Imaging’s Deals
Among the more interesting dramas unfolding in the medical imaging profession these days are the number and variety of transactions that are either in the pipeline, in the process of due diligence, or otherwise in some organization’s strategic plan for 2010.
The Mayo Clinic Vision: Radiology’s Role in Care Delivery
Integrated health care delivery systems such as that pioneered by the Mayo Clinic, Rochester, Minnesota, have been heralded for their low-cost, high-quality care and greater efficiency.
Of Competitors and Superheroes
An eerie presence had descended on Gotham, and ordinary imaging providers in and around New York were worried.
Cracking the Code for Improving Quality
As the entire health care continuum comes under increased scrutiny in terms of both cost and effectiveness, radiologists and administrators alike have fresh cause to contemplate quality in the delivery of imaging services.
The ACR and Its Real-world B-school
Radiology is stepping up to the very difficult challenges it faces with the help of an expanding cadre of strong leaders
The Netflix Cultural Revolution
When Netflix posted a PowerPoint® presentation detailing its culture on the Internet
How Culture Informs Hiring
One of the greatest risks taken by a radiology practice with a formal corporate culture in place is that of hiring personnel who will not support its values.
The Cultural Revolution: Two Case Studies on Corporate
Private and public companies alike have long sown the seeds of success by conceiving and adhering to a corporate culture that dictates how employees interact with customers and clients, as well as with each other.
Strategy Before Structure, Blue Ocean Style
Business strategy has been proceeding backward for three decades or more, according to the authors of Blue Ocean Strategy.¹
Raising the Voices of Radiology
Radiology has a very human story to tell, and its grassroots coalition in New York is engaging the support of elected officials to avert a second round of crippling imaging cuts
Grand Junction: The Role of Radiology in an Integrated Delivery System
In the June 1, 2009, issue of The New Yorker,¹ surgeon-journalist Atul Gawande, MD, MPH, introduces the world to two US cities that, when contrasted with one another, expose the wide gulf in the cost of US health care delivery and outcomes: McAllen, Texas, and Grand Junction, Colorado
MIPPA’s Impact on Imaging
At the 2009 annual meeting of AHRA: The Association for Medical Imaging Management in Las Vegas, Nevada, on August 12.
Forging Multigenerational Teams in Radiology
A satisfied generation X worker is getting more than a paycheck—and is doing more than following instructions, according to Lisa Landry, MBA, MRT(N), Children’s Hospital of Michigan, Detroit.
Whom Do You Trust?
There is perhaps no greater indicator of an organization’s cultural health than the degree to which members of the group—really, a community—trust one another.
Radiology’s Role in Limiting Health Care–acquired Infections
In a session at this month’s meeting of AHRA
Whom Do You Trust?
There is perhaps no greater indicator of an organization’s cultural health than the degree to which members of the group—really, a community—trust one another.
OIC Deployment: Buy, Build, Sell, or Hold?
Tight credit markets may have lengthened timelines, but hospital systems across the United States continue to move aggressively into their communities to fulfill outpatient imaging strategies.
The Evolving Radiologist-hospital Relationship
It was the contract termination heard ‘round the world when Florida Radiology Associates (FRA) ended its 40-year relationship with Florida Hospital last year.
Heroes in Proving the Value of Imaging: Part 3
Heroes in Proving the Value of Imaging is an occasional series about advocates for the profession who are working to enhance radiology through research, governmental affairs, humanitarian efforts, and more.
Protecting Radiology Through Credentialing
According to David M. Yousem, MD, MBA, serving on your hospital’s credentialing committee is far more important than you might think.
OIC Strategy: Build, Buy, or Sell
Recognizing that outpatient imaging revenue is far too important to the bottom line to forfeit the business to aggressive and nimble entrepreneurs, hospitals and health systems have moved aggressively into their communities in recent years with their own outpatient imaging center initiatives.
Leading Large in Michigan
As practices merge to gain leverage and broad subspecialty expertise, they also encounter commensurate new leadership challenges in governing ever-larger groups of independent-minded members.
The Current State of Radiology Administration
Penny Olivi, CRA, FAHRA, RT dishes on managing a radiology department and an academic practice in 2009.
The Digital Dilemma: More than a Can of Paint
A disturbing trend is clearly visible in the marketplace: too many new imaging facilities are out-of-date by the time they are initially operational.
Leadership in Radiology
What’s expected of leaders in radiology has changed, Frank J. Lexa, MD, MBA, informed his audience at the 23rd Annual Economics of Diagnostic Imaging 2008: National Symposium
PQRI: Money on the Table
Medicare made more than $36 million in payments to more than 56,000 physicians who participated in the Physician Quality Reporting Initiative in 2007.
The Practice CIO: Driving Business Innovation
CIOs are playing a key role in moving the clinical and business operations of the radiology practice into the 21st century
Ten Steps to ARRA
Charles Christian, CIO, Good Samaritan Hospital, Vincennes, Ind, identifies the following steps that organizations should take to position themselves to receive their share of the American Recovery and Reinvestment Act funds earmarked for health care IT.
The Future of Hospital-based Outpatient Imaging
Is outpatient imaging on the hospital campus still strategically relevant for hospitals and health systems?
Productivity Tracking for Radiologists
Because there are not enough radiologists available to meet demand, practices must learn to make the most of radiologists’ available time, according to a paper presented in Chicago at RSNA 2008.
Heroes in Proving the Value of Imaging: G. Scott Gazelle, MD, MPH, PhD
Heroes in Proving the Value of Imaging is an occasional series about radiology professionals whose work demonstrates the value of the specialty through research, governmental affairs, humanitarian efforts, and more.
Atlas Scanned
In trying to understand the current shift in economic and political winds, I thought it would be helpful to take a new look at a classic depiction of the US capitalist system, as portrayed in one of American fiction’s great works.
Reinventing the Radiology Practice
Radiology practices must be nimble enough to reinvent themselves if they are to thrive, according to Fred Gaschen, MBA, CHE. Gaschen, executive vice president of Radiological Associates of Sacramento, Calif, presented “Reinventing Your Radiology Practice” on October 24, 2008.
Thoughtful Management for Hard Times
Historically, financial downturns have not affected the health care industry, but it is not so this time.
Radiology: Ancillary No More
Radiologists must counteract practice developments that can result in trivializing their specialty’s contributions to medicine
Commoditization of Imaging: What Can Radiologists Do Now?
As telecommunications technology advances, rocking the age-old paradigm of the radiologist tethered to a lightbox, radiologists have freedom as never before.
Heroes in Proving the Value of Imaging: Part 1
Heroes in Proving the Value of Imaging is an occasional series about advocates for the profession who are working to enhance radiology through research, governmental affairs, humanitarian efforts, and more. In Part 1, ImagingBiz speaks with academic leader Bruce Hillman, MD.
Patient Surveys Guide Competitive Strategies
Asking customers what they need is one of the best ways of retaining their business, in the experience of Frank J. Lexa, MD, MBA.
Summit Radiology CEO Mark Schaefer: The Role of IT in Building the Practice
The story of Summit Radiology is in some respects archetypal: the story of the modern radiology practice.
Bolstering the Team: Outsourcing Final Interpretations and Billing
For Kalvinder Sumra, MD, medical director at Pembina County Memorial Hospital, Cavalier, ND, the challenge has never been keeping his radiologists happy.
Radiology in an Economic Downturn Strategies for Success
In the near term, radiology practices must turn their attention to managing expenses instead of growth.
The Push for Productivity
In an era of declining reimbursement for radiology, one practice is testing the limits of IT’s ability to improve productivity
Building the Model Practice
Corporate-style governance, subspecialization, and choosing the right administrative staff members all play roles
FRA and Florida Hospital: A Cautionary Tale Unfolds
After 40 years, a 47-physician group ceased to exist, a casualty of current medical economics, internal strife,and failed negotiations
Understanding—and Adapting to—Managed Care Strategies
It is highly probable that many practices will see their current payor mix change to one in which 80% or more of net patient revenues will be based on negotiated payments,” according to Christopher J. Kalkhof, FACHE, director and national managed care lead, Provider Revenue Cycle Practice, Deloitte Consulting, New York City.
Packaging Versus Bundling: Let the Battle Begin
There are very important differences between packaged services and bundled services. Unfortunately, many people use these terms interchangeably, which may result in incorrect coding practices (and, potentially, in lost revenue for the organization).
Buy, Sell, or Hold: Selling Your Diagnostic Imaging Business
I was recently speaking with a client of mine who had spent about eight years growing his diagnostic imaging company.
A Formula for Budget-based Marketing
Not long ago, I sent a memo to a select group of clients informing them that as of January 9, 2009, pharmaceutical representatives would no longer be distributing the so-called dry goods.
Consumer-driven Health Care: Dealing With the Impact on the Physician Revenue Cycle
The health care industry will be facing significant changes in the future, and a medical practice’s success is becoming increasingly linked to its revenue cycle.
Role of the Center Manager: Driving Productivity by Nurturing Cooperation
The team at OGH Imaging LLC, Grand Coteau, La, faces a daunting task every day.
Palm Beach Radiology Institute: Digital Out of the Box
At Palm Beach Radiology Institute, operated by Palm Beach Radiology and Imaging Associates (PBRIA), there is no film, there never has been film, and no one expects ever to see film.
NightHawk Offers Model for QA
It’s easy to let quality assurance (QA) slip into a lip-service category, but that is something that a nighttime stat-reading teleradiology service can’t afford to do—particularly if it is an industry leader like NightHawk Radiology Services.
Tomorrow’s Successful Imaging Leaders
In despair at the way its programs were organized, the business school at one university recruited as the director of programs a successful businessman.
What is Quality Radiology?
The 1999 Institute of Medicine report To Err Is Human¹ brought the extent and severity of medical errors to the attention of policymakers, hospital administrative staff, and health care providers.
Physician Productivity Tracking Takes Hold
No matter how common measuring productivity becomes, there is a deficiency behind it: tracking does not always reflect reality and, as a result, can cause diligent workers to appear less productive.
