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Provided by Regents Health Resources
Regents Health Resources was formed in 1996 to assist hospitals and physicians in the development and management of their medical-imaging and oncology services. The consultancy has served more than 500 clients nationwide with a diverse range of services, from strategic planning and operational assessments to joint-venture planning, valuations, and imaging-center sales and acquisitions.
Forecasting Imaging Use Under Health-care Reform
A key element of the Patient Protection and Affordable Care Act (PPACA) is extending coverage to uninsured individuals, which raises a number of questions in the imaging marketplace. What is the predicted impact on utilization in 2015, when an estimated 31 million formerly uninsured people will join the ranks of the insured? With continued downward pressure on reimbursement for the technical component of outpatient imaging, will there be enough capacity and resources to accommodate the new patients? This edition of Imaging Market File provides an estimated state-by-state impact of health reform on imaging use, which adds up to 13.6% growth nationally
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Outpatient Imaging Utilization Trends
Beginning with the DRA of 2005, a cascade of negative reimbursement pressures— including exam bundling, a weak economy, radiology benefit management programs, and the adoption of appropriateness criteria—has had an effect on historical outpatient imaging utilization trends. This fourth installment of the Imaging Market File explores utilization trends, by modality, for hospital outpatient and freestanding outpatient locations nationally, from 2007 to 2010, while identifying the regulatory and economic factors that are likely to have had an impact on these trends (using complementary timelines). The database includes volumes from 96 outpatient imaging providers and 24 hospitals in 14 states. Total outpatient exam volume is 13.7 million, from 2007 through 2010.
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The Radiology Staffing Market, Temporary and Permanent
Introduction:As pressures on reimbursement and utilization continue to have an impact on the imaging market place, radiology-staffing data suggest a shift in the availability and use of professional services over the past decade. This installment of the Imaging Market File tracks current and recent developments in the supply of radiologists, the demand for their temporary (locum tenens) and per- manent services, and related staffing trends, based on data collected by AMN Healthcare (San Diego, California) and Staff Care (Irving, Texas).
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Radiology-group Financial Performance
Introduction: This third installment of the Imaging Market File tracks four key financial-performance measures over time: payor mix, receipts per unit of service, administrative-infrastructure expense, and total physician compensation. The dataset includes professional-component services only, billed by 112 hospital-based radiology groups ranging in size from eight members to 94 members; the groups are located in the Northeast, Mid-Atlantic, Midwest, Southwest, and Northwest regions.
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Cost Comparison: Hospital-based Versus Freestanding Outpatient Imaging Services
Introduction: This second installment of the Imaging Market File quantifies the cost variance between hospitals and freestanding centers by comparing four major direct-expense lines in imaging operations: staff benefits and costs, supply costs, depreciation, and other direct costs. This by no means represents the total cost of operating imaging services. This analysis does not include indirect costs, such as facility costs, administrative costs, and imaging IT hardware and software. These results represent a total of 55 unique locations (33 hospitals and 22 imaging centers), more than 2.3 million exams, and nearly $1 billion in revenue during 2009 and 2010.
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Hospital-based Versus Freestanding Outpatient Imaging Services
Introduction: The first installment in the Imaging Market File is based on data from the National Imaging Network (NIN), an outgrowth of the hospital and radiologypractice consulting work of Regents Health Resources, a medical-imaging consultancy based in Franklin, Tennessee. In 2009, Regents Health Resources began developing the Web-based tools that would constitute the back end of the network and enable members to access their own disparate data easily while comparing their results to national and regional performance benchmarks, as well as to those from similar settings.
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CT and MRI: Regional Variations in Utilization and Reimbursement
Introduction: Imaging operations need to understand current utilization rates and patterns in their local markets to deter- mine their relative rates of exam capture and to plan for future needs. This issue of Imaging Market File looks at national utilization rates (per 1,000 people) for outpatient CT and MRI procedures, ac- cording to Thomson Reuters (New York, New York) by age and by region (Table 1) as defined by AHRA: The Association for Medical Imaging Management. Reimbursement rates were based on Medicare outpatient rates from the Medicare Physi- cian Fee Schedule (MPFS) of 2010, 2011, and 2012, and were calculated by averag- ing regional CPT® code mixes.
The Jig Is Up
For many years, hospitals and physician practices have engaged with payors in a little game we play in a free market society called “negotiation.” This game enables the players to use whatever tools and stratagems they possess to leverage as good a price possible for their services/business in an increasingly price-conscious marketplace. On the provider side, good means high, and on the payor side, good means low. Providers might negotiate from a position
