Macroeconomics
Preparing for Potential Reform: The Hospital View
Some proponents of national health care reform expect to pop the champagne corks any day now in celebration of getting a bill through Congress.
ImagingBiz Newsletter, January 18, 2010Using Next-generation IT Tools to Improve Appropriateness
It might well have been the unofficial theme of RSNA 2009 in Chicago, Illinois: “You can’t change what you can’t measure.”
Radinformatics, January 10, 2010Too Big to Understand
I just finished reading the new book about last year’s financial near meltdown, Too Big to Fail (Viking, 2009), by Andrew Ross Sorkin.
ImagingBiz Newsletter, December 21, 2009Window on 2010: Impact of Imaging-Specific Health Care Reforms
Since the dawn of the DRA at the close of 2005, health care observers have predicted a follow-on DRA II. It appears that this prediction will come to pass shortly after the clock strikes midnight on December 31.
ImagingBiz Newsletter, December 21, 2009Now, for Something Completely Different
As I sit here trying to think of a way to wrap up a year of tremendous change in radiology, health care, and the economy at large, I understand that there is no way to turn 2009 into a neat package.
Radiology Business Journal, December 01, 2009Malpractice Premiums: MIA in the Health Care Debate
Health reform efforts have developed into a heated and contentious debate.
Radiology Business Journal, December 01, 2009Alternative Imaging Business Structures and Arrangements: What’s Legal?
The changing regulatory landscape for imaging business structures has left considerable uncertainty about which arrangements are acceptable in the eyes of the law
Radiology Business Journal, December 01, 2009Cost of Care to Elderly Soars
During the decade following 1996, the average annual cost of health care for those 65 and older increased 30%, according to a recent analysis.1
Radiology Business Journal, December 01, 2009A Call to Action
Any reader of Radiology Business Journal knows that the complexity and intensity of managing a radiology practice are increasing exponentially.
Radiology Business Journal, December 01, 2009The 50 Largest Radiology Practices
Our second annual survey indicates that the big are getting bigger, the average number of imaging centers owned is trending lower, and nearly all of the nation’s 50 largest private radiology practices are providing some level of teleradiology
Radiology Business Journal, December 01, 2009Grassroots Coalition Puts Collaboration Above Competition
The rival groups had targeted the same pool of patients in their marketing efforts, positioning their respective imaging facilities, in one of the most competitive markets in the country, as the best that the Big Apple had to offer.
ImagingBiz Newsletter, November 18, 2009ACR Economic Update: What to Expect From CMS in 2010
While health reform is still a legislative preoccupation, where regulatory agencies are concerned, the train has left the station, according to Maurine Spillman-Dennis, MPH, MBA. Spillman-Dennis is a senior director in the economics and health policy division of the ACR®, and she presented an economic update from the college at the RBMA Fall Educational Conference on October 12, 2009, in Phoenix, Arizona.
ImagingBiz Newsletter, November 18, 2009Sunshine Bill Renews Focus on Conflicts of Interest
While health care players and politicians have long debated the issue of medical transparency.
ImagingBiz Newsletter, October 14, 2009Health Care Efficiency: No Miracle Cure
Health care reform ideas are everywhere these days.
ImagingBiz Newsletter, October 14, 2009DRA II: CMS Proposes Slashing the Technical Component Again
A proposed 90% equipment-utilization formula and brand-new lowball practice-expense data courtesy of the AMA will deal radiology a new round of cuts comparable to those contained in the DRA.
Radiology Business Journal, October 01, 2009Now, the OIG Takes Aim
Yet another wearisome attack on imaging from Washington begs a question: Will decision makers ever get to the real roots of health care inefficiency?
Radiology Business Journal, October 01, 2009Isotope Shortage Hinders Nuclear Medicine
It was the worst news that the nuclear-medicine community could receive when, on August 12, Atomic Energy of Canada Ltd (AECL), Chalk River, Ontario, announced that the National Research Universal (NRU) reactor would remain shut down until at least January 2010.
ImagingBiz Newsletter, September 10, 2009OIC Reimbursement: The Multipronged Attack
In an illustration used for hospital clients, analyst Shay Pratt pinpoints imaging centers for sale around the country
ImagingBiz Newsletter, September 10, 2009Too Much Health Care?
Of all the issues facing today’s imaging executives and radiologists, none sounds more cacophonous than the nearly universal cry that the United States spends too much on its health care.
ImagingBiz Newsletter, September 10, 2009Radiology Braces for Change Ahead
Some US employees still enjoy Cadillac-style health plans in which little is paid out of pocket and coverage includes almost every health need, but health care costs for its workers helped send Cadillac maker General Motors into bankruptcy.
Radiology Business Journal, September 09, 2009The Invisible Radiologist Meets the New Math, Climate Change, and Business 101
A leading industry analyst suggests that radiology practices and hospital imaging executives must adapt to the new order or risk extinction
Radiology Business Journal, September 09, 2009The 25% Administrative Complexity Conundrum
A modest 10% optimization of health care’s administrative processes would save the US health care system $500 billion over 10 years.
Radiology Business Journal, September 09, 2009Adding Patient Value to Health Care
Harvard professor, best-selling business author, and management consultant specializing in competitive advantage Michael E. Porter, PhD, offers his free-market spin on health care reform¹ in the July 8, 2009, issue of the New England Journal of Medicine.
Radiology Business Journal, September 09, 2009Against the Sword of Damocles
Radiology will fare better under reform than in its absence; it is advisable to join the battle
Radiology Business Journal, September 09, 2009The Demise of Reason (and Eating Crow)
When politics enters the health care debate, reason departs
Radiology Business Journal, September 09, 2009Quantifying Imaging’s Value to Patients
Contrary to popular belief among regulators and payors, imaging studies do, in fact, contribute to improved patient care.
ImagingBiz Newsletter, August 18, 2009Health Care Reform and Medical Imaging: The 10,000-foot View
The Obama administration is pursuing an aggressive timetable to deliver on a campaign promise to make affordable health care available to all US residents.
ImagingBiz Newsletter, August 18, 2009MSDRGs: Pitfalls and Opportunities
Ernest Glad, president of Cortell Health, Dallas, Texas, sees the 2007 CMS restructuring of the DRGs used in the inpatient prospective-payment system as an opportunity that many hospitals are currently squandering.
Medical Imaging Review, July 26, 2009Coalition Forms to Promote Clinical Decision-support Tools
In June, an alliance of health care providers, technology vendors, and imaging organizations announced the formation of the Imaging e-Ordering Coalition
ImagingBiz Newsletter, July 15, 2009Radiology and the Culture of Money
Let’s get the full disclosure part out of the way right up front.
ImagingBiz Newsletter, July 15, 2009RBMs: The Debate Heats Up
After a false start, RBMs have come on strong, but the advent of computerized physician order entry leads some to believe there are better ways to control imaging utilization
Radiology Business Journal, July 01, 2009Pandora and the Very Scary Box
Out of the box flew all of mankind’s misfortunes
Radiology Business Journal, July 01, 2009Radiology and the Culture of Money
Let’s get the full disclosure part out of the way right up front.
Radiology Business Journal, July 01, 20092009 MedPAC Report: A New Threat to High-quality Care
In 1997, Congress created the Medicare Payment Advisory Commission (MedPAC) to provide recommendations regarding health care policy and reimbursement with respect to the Medicare program.
ImagingBiz Newsletter, June 15, 2009Grassroots Activism 101
War stories from the first assault on imaging.
ImagingBiz Newsletter, June 15, 2009Health Care Tomorrow: A Revisionist Preview
Jeff Goldsmith predicts that, despite inevitable changes, the future of health care is more sound than many people believe.
ImagingBiz Newsletter, June 11, 2009Extreme Subspecialization Builds Its Own Knowledge Base
“The more you see, the better you are,” Javier Beltran, MD, FACR, says.
ImagingBiz Newsletter, May 15, 2009Breakeven Modeling for a Multimodality Imaging Center
In the 1980s and 1990s, payor fees were generous for the newest modalities, and most freestanding imaging facilities were quite profitable.
ImagingBiz Newsletter, May 15, 2009ARRA Update: Opportunities and Risks for Health IT
The American Recovery and Reinvestment Act of 2009 (ARRA)
ImagingBiz Newsletter, May 15, 2009Recovery Audit Contractors: Coming Soon to a Provider Near You
Medicare providers and suppliers nationwide have been preparing for increased Medicare audit activity in anticipation of the nationwide rollout of the permanent Recovery Audit Contractor (RAC) Program.
ImagingBiz Newsletter, April 15, 2009MGH Decision-support Study: A Shot Across the RBM Bow
A new study¹ finding that radiology order-entry (ROE) and decision-support (DS) tools act to curtail utilization rates for advanced imaging is being celebrated as proof that a White House proposal to deploy radiology benefit managers (RBMs) as Medicare gatekeepers is unnecessary and ill conceived.
ImagingBiz Newsletter, April 15, 2009CMS Decision on CTC Prompts Restrategizing
The CMS decision to retain nonapproval status for CT colonography (CTC) as a screening method for Medicare patients was a bitter pill for radiology to swallow—all the more bitter because, prior to the February 11 decision, the mood had been optimistic.
ImagingBiz Newsletter, March 15, 2009Prove It
It is time for the specialty to take a proactive role in evidence-based radiology
Radiology Business Journal, March 01, 2009Further TC Cuts Ahead?
Due to inequities in payment methodology, are providers of imaging services overpaid?
Radiology Business Journal, March 01, 2009Under the Influence of RBMs
It’s no secret that utilization control has emerged as the method of choice for private payors focused on reining in imaging costs.
Radiology Business Journal, March 01, 2009Health Reform’s Shortest Era
He came. He saw. He vanished. Just as we health care journalist types were lining up the margins and checking references on our various predictions of what Tom Daschle would bring to the health reform debate and process, he bequeathed his White House office to his deputy in waiting.
ImagingBiz Newsletter, February 15, 2009ACR and RBMA Update on Congressional Activities and Medicare Payment Policies
On December 16, 2008, the RBMA hosted a Webinar to update members on ACR congressional activities and Medicare’s payment policies for 2009.
ImagingBiz Newsletter, February 15, 2009The Outpatient Imaging Forecast Is Mixed, but Growth Is Ensured
In November 13, 2008, GE Healthcare, Waukesha, Wis, hosted a webinar entitled Interpreting the Future of Medical Imaging.
ImagingBiz Newsletter, December 15, 2008Revised Anti-markup Rule: CMS Gets Creative
On November 19, 2008, CMS issued the Medicare Physician Fee Schedule (MPFS) for calendar year 2009.
ImagingBiz Newsletter, December 15, 2008The 50 Largest Radiology Practices
Why compile a list of the 50 largest radiology practices? We acknowledge that the list is far from complete, and that there may be some inconsistencies in the way that respondents answered the questions.
Radiology Business Journal, December 01, 2008Health Care Delivery, Undisrupted
How to afford health care is not the question we should be asking in these times of unsustainable health care cost increases.
Radiology Business Journal, December 01, 2008Maintaining a Steady Aim at a Moving Target
An overview of recent regulatory changes affecting diagnostic imaging
Radiology Business Journal, December 01, 2008Busting Myths: Joint Ventures
Radiology groups should understand the tax implications of arrangements with hospitals before they begin negotiations, according to W. Kenneth Davis, Jr, JD.
Radiology Business Journal, December 01, 2008Major Advances in Osteoporosis Assessment: New NOF Guidelines and the’s FRAX Risk-assessment Tool
Osteoporosis is a major public-health problem, with an estimated 44 million US residents at risk for fracture.¹
Radiology Business Journal, December 01, 2008Regulatory Report: Gains Made in Campaign to Limit Self-referral
Organized radiology has been devoted to the self-referral issue for more than a decade.
ImagingBiz Newsletter, November 15, 2008Time to Unwind, and Other Effects of the 2009 MPFS
Few federal rules for billing and leasing of diagnostic testing equipment and technicians by mobile testing companies will require the restructuring or unwinding of many imaging arrangements prior to the end of 2008.
ImagingBiz Newsletter, November 15, 2008Evaluating Mergers and Acquisitions
The forces driving mergers and acquisitions in imaging will only intensify, according to the presenters of Legal and Regulatory Issues Facing Outpatient Imaging Centers.
ImagingBiz Newsletter, October 15, 2008New Rules of the Game: Medical Directors Assume the Quality Burden
Demand for radiologists acting as medical directors could jump if a proposed regulation now under consideration by CMS is adopted.
ImagingBiz Newsletter, October 15, 2008The Dynamics of Reimbursement and High-quality Care
Access to high-quality patient care is a cornerstone of customer-focused service delivery, Michael A. Silver, PhD, says.
ImagingBiz Newsletter, September 15, 2008The Next Wave: Compliance With Medicare IDTF Standards Requires Ongoing Diligence
To say that the health care regulatory environment has been active over the past two years would be an understatement.
ImagingBiz Newsletter, September 15, 2008Economic Summit 2008: Audience Response
A survey of attendees at a May 2008 meeting has yielded a snapshot of today’s primary concerns for radiology practices.
Radiology Business Journal, September 01, 2008Minnesota’s Bold Experiment: Radiologist as RBM
In June 2008, the Government Accountability Office (GAO) released a long-awaited study on imaging utilization.
Radiology Business Journal, September 01, 2008Contest of the Implausibles
In an often-hilarious talk at the Beyond Conference in Washington, DC, on July 24, 2008.
Radiology Business Journal, September 01, 2008CMS Proposes Changes to the Anti-Markup Rule: Round Two
The only constant is change is an apt mantra for the imaging industry over the past several years.
Radiology Business Journal, September 01, 2008Proposed 2009 MPFS: Once Again, Imaging Takes a Disproportionate Impact
In what seems to be becoming as much a harbinger of summer as fireworks or cookouts, on July 7, 2008, CMS published its proposed Medicare Physician Fee Schedule (MPFS) payment update for the next fiscal year.
ImagingBiz Newsletter, August 15, 2008Recovery Audit Contractors and Medicare Audits: Successful Strategies for Defending Audits
The CMS Recovery Audit Contractor (RAC) program has been made permanent and is expanding nationwide, beginning this year.
ImagingBiz Newsletter, August 15, 2008CT Colonography: Ready for Prime Time
On June 18, 2008, a letter was sent to the CMS Coverage and Analysis Group seeking approval of CT colonography (CTC) as a generalized screening tool for colorectal cancer among asymptomatic Medicare patients 50 years of age or older.
ImagingBiz Newsletter, July 15, 2008Precertification: The Provider Foots the Bill
Is radiology benefit management (RBM) companies extend the reach of precertification and preauthorization programs, hospitals and physician practices across the nation are incurring significant personnel and software costs in their efforts to manage program requirements.
Radiology Business Journal, June 15, 2008Radiology Income Distribution: From Salary to Independent Practice to Megapractice
A CPA offers his perspective on the past and future of radiologist compensation, based on 30 years on the business side of radiology
Radiology Business Journal, June 15, 2008Ethics, Steerage, and a Level Playing Field
How you feel about the issue of patient steerage depends, of course, on whether you are the beneficiary of a steady stream of unsuspecting patients being directed your way by payors determined to control every aspect of the delivery system.
Radiology Business Journal, June 15, 2008RBM to Broker Teleradiology Services
A corporate offshoot of radiology benefit management (RBM) company MedSolutions, Nashville, Tenn, has begun marketing a program of subspecialized teleradiology services to payors.
Radiology Business Journal, June 15, 2008Legislative Report: Another Temporary SGR Fix Is in the Wings
The CMS Sustainable Growth Rate (SGR) is again the center of attention for the medical community.
ImagingBiz Newsletter, June 12, 2008Trends in Mergers and Acquisitions in the Diagnostic Imaging Sector
There is little question, and ample evidence, that merger-and-acquisition activity in the diagnostic imaging business sector has increased since the Deficit Reduction Act (DRA) in 2005, and since Medicare Physician Fee Schedule changes and IDTF Standards changes in 2006 and 2007.
ImagingBiz Newsletter, June 12, 2008Contract Evaluations: The Devil in the Details
An adage of the legal profession holds that if you’ve seen one contract, you have seen exactly one contract.
ImagingBiz Newsletter, June 12, 2008Ten Trends, Five Years: Predictions for Outpatient Imaging
While long-term forecasts are always subject to error in a changing climate, today’s market trends can provide strong, reliable indications of what to expect in the future.
ImagingBiz Newsletter, May 15, 20082008 Update on Non-hospital-based Outpatient Medicare Reimbursement
As part of GE Healthcare’s commitment to ongoing monitoring of the reimbursement situation, GE presented a Webcast on this topic on May 7, 2008.
ImagingBiz Newsletter, May 15, 2008CHAMP, Sustainable Growth Rate Reform, and Other Potential Payment-reduction Vehicles
Today’s imaging market is substantially different from that of earlier years; payment is less secure, coverage for new technology is more difficult to obtain, and government and private oversight are increasing.
ImagingBiz Newsletter, April 15, 2008Radiology’s Next Big Policy Fight
A conversation with Jeff Goldsmith, PhD, is, by definition, unpredictable and always provocative.
Radiology Business Journal, March 15, 2008Outpatient Imaging Forecast: More Volume, Slower Growth, Heightened Competition
Strong growth, particularly for advanced imaging studies like CT, MRI, and PET/CT, has increased imaging volumes and profits at an unprecedented rate over the past decade.
Radiology Business Journal, March 15, 2008National Health Spending for 2006
EACH YEAR, THE CMS OFFICE of the Actuary and the National Health Expenditure Accounts (NHEA) Team compile figures reflecting US health expenditures, and the results are published, with analysis, in Health Affairs.
Radiology Business Journal, March 15, 2008Hospitals Still Outnumber Imaging Centers but the Gap Is Closing
Diagnostic imaging centers continued their growth trajectory well into 2007, according to the latest Diagnostic Imaging Center Report from Verispan, Yardley, Pa.
Radiology Business Journal, March 15, 2008Trends in Imaging Arrangements
Prior to 2007, medical practices that developed and used imaging facilities on an exclusive, full-time basis were not overly scrutinized by payors or regulators.
ImagingBiz Newsletter, March 15, 2008A Thorny Question: Who is Responsible for Transcription Costs?
Radiology practices and hospitals historically have operated under the assumption that the cost of transcription is part of the technical component, and therefore the responsibility of the hospital, or the entity that owns the technology.
ImagingBiz Newsletter, March 15, 2008The Shifting Landscape of Cardiac CT Angiography Reimbursement
Many imaging providers have been wishing for changes in reimbursement policies for cardiac CT angiography (CCTA) for some time.
ImagingBiz Newsletter, February 15, 2008Consolidation Ahead: Imaging Mergers and Acquisitions
Over the past 10 years or so, there have been distinct phases in mergers and acquisitions in the medical imaging market.
ImagingBiz Newsletter, February 15, 2008Caution Ahead: Keep Your Eyes on the Road
The imaging industry was able to beat back more than a billion dollars’ worth of cuts in Medicare in a bill that President Bush signed into law on December 30, 2007.
ImagingBiz Newsletter, January 15, 2008Canada’s Number–one Imaging Provider Acquires American Radiology Services
CML HealthCare Income Fund, Mississauga, Ontario, has entered into a definitive agreement to acquire Baltimore-based American Radiology Services (ARS) for $151 million.
ImagingBiz Newsletter, January 15, 2008Practice Buyouts: What Should a Departing Physician Really Receive?
The largest asset of a radiology practice is the cash value of its accounts receivable, and that valuation is prominent in the deferred-compensation package for a retiring member.
ImagingBiz Newsletter, January 15, 2008Washington’s Low-Hanging Fruit: Diagnostic Imaging
In the world of Washington politics, health care and health care policy are high stakes and high profile.
ImagingBiz Newsletter, December 15, 2007Regulatory Report: The Final Rule: Part-Time Lease Deals Out, Other Stark Measures on Hold
In last year’s Medicare Physician Fee Schedule (MPFS) proposed rule, CMS described its concerns for the potential for fraud, waste and abuse of the Medicare program that may be caused by the growth of so-called “pod” or “condo” laboratories.
ImagingBiz Newsletter, November 15, 2007Legislative Update: Calculating the True Cost of the DRA
As the medical imaging industry is well aware, the Deficit Reduction Act of 2005 (DRA), effective January 1, 2007, directed severe reductions in payments for many imaging services in the physician office and independent facility setting.
ImagingBiz Newsletter, October 15, 2007RBMA DRA Mini-Survey: Most Practices Expect to Cut Radiologist Pay
A significant percentage of practice managers responding to a survey from the Radiology Business Management Association said radiologists would take a pay cut in 2007 if the DRA is not rolled back.
ImagingBiz Newsletter, September 15, 2007Letter-Trafficking and Self-Referral in Massachusetts
As in many states, Massachusetts policy makers are examining the impact that ambulatory surgical centers and medical diagnostic imaging services, particularly physician owned, are having on the health care delivery system.
ImagingBiz Newsletter, September 15, 2007Sg2: More than 90% of Decade’s Imaging Growth Will Occur in Outpatient Sector
Imaging will grow a respectable but relatively sedate 12% to 14% over the next 10 years, and the vast majority of that growth will occur in the outpatient sector.
ImagingBiz Newsletter, September 15, 2007Do Proposed MPFS Changes Portend the Demise of Block Leases?
Although block-leasing arrangements have become increasingly marginalized given recent Board of Medical Examiner decisions and a spate of high profile whistleblower cases, such arrangements clearly remain a target for the Centers for Medicare and Medicaid Services (CMS).
ImagingBiz Newsletter, August 15, 2007Post-DRA Roundup: The Good, the Bad, and the Downright Ugly
I have been asked to provide our experience, so far, in 2007, with respect to the impact of DRA 2005 on imaging centers.
ImagingBiz Newsletter, July 15, 2007Legislative Report: Maryland Radiologists Defends State’s Anti-Self Referral Law
In 1993, the Maryland General Assembly passed legislation to prohibit self-referrals by physicians for three types of imaging services to patients.
ImagingBiz Newsletter, June 15, 2007Legislative Report: CMS Transmittal Rocks IDTF World
Just as imaging center operators thought they had a handle on the inhospitable reimbursment and regulatory environment for 2007.
ImagingBiz Newsletter, June 12, 2007NCQDIS: Now More than Ever
Those of us in the industry recognize that imaging is a fast-growing alternative to invasive procedures. New technology, an aging population, and declining costs of equipment are leading to more imaging procedures being performed each year.
ImagingBiz Newsletter, June 12, 2007EMI: The Last Cost-Cutting Frontier
The changing outpatient imaging business environment has made it imperative for all radiology managers to continually reduce operating expenses.
ImagingBiz Newsletter, June 12, 2007
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