Imaging's “Hail Mary” Moment
By Curtis Kauffman-Pickelle

You know the scene. The big football game is down to the final two minutes and the score in the cross-town rivalry is agonizingly close. The only way for our favored team to win is to launch a last-minute pass down field in the vain hope that amidst the chaos the ball will somehow find its way into the hands of our receiver and he will get into the end zone. It’s known as a Hail Mary pass precisely because its chances of success are extremely slim and one hopes for divine intervention to ensure miraculous success.

So here we are. The mid-term elections are nearly upon us. Democrats and Republicans are slugging it out to a close finish on a host of very complex and profound political-football issues, any one of which could keep lawmakers from paying even scant attention to the Access to Medical Imaging Coalition initiative and related DRA-rollback legislation.

No, the game is not yet over: there is work still to be done, lobbying calls to be made, charts and graphs yet to be drawn, a lot of turf still to be pounded. The fight remains intense and all of us are in it to the finish. Yet in the huddles taking place in boardrooms at outpatient imaging practices around the country the discussion is turning increasingly to how one emerges in January as a survivor within an entirely new model of competitiveness. One senses a certain resignation now driving '07 budget preparations.

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Attention, All Campers
By Liz Quam

Much has been said and written about the significant economic effect the Deficit Reduction Act of 2005 (DRA) will have on the imaging industry. For many, imaging expansion plans have been stopped, development or equipment sales departments have been downsized, and equipment purchases and upgrades have been placed on hold or cancelled.

Considerable human and economic resources have been expended to publicize what, quite literally, happened in the dark of night in Washington, DC. Activities are underway to analyze the DRA’s full effect while seeking ways to change it—or, at least to lessen its damaging effects.

From a business perspective, the imaging industry seems to have divided itself into three camps.

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Investment in
Human Capital
By Nicole Pliner

As I travel across the country and visit radiology practices, I am increasingly surprised at the disproportionate investment in human vs non-human capital. While these organizations will spend millions of dollars to purchase new technology or to upgrade equipment, they will allocate relatively little to train the staff who are actually charged with operating this expensive capital.

If you look at it on a percentage basis, I think the numbers will startle you. Take, for example, an organization that spends $3 million on a PACS while only permitting the PACS Administrator to go to one information technology conference, an expense of approximately $3,000. Or, consider the organization that makes a capital investment in speech recognition but only allocates funds for one week of on-site support. And where is the wisdom in the radiology practice that purchases a new CT scanner for more than $1 million, but only allows the senior technologist to go for offsite training?

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Shot Fired Over the Bow

If the recent OIG report detailing independent diagnostic testing facility (IDTF) abuses was a warning flare, then the tough new restrictions on IDTF operations contained in the proposed Medicare Physician Fee Schedule of 2007 is a shot fired over the bow. Published in the August 22 Federal Register, the proposed rule not only implements the cuts to imaging contained in the Deficit Reduction Act, but institutes tough new restrictions on IDTF operations. Although the proposed rule cites as cause for concern some of the more egregious examples of self-referral exhibited by the so-called “pod” and “condo” pathology laboratories, the restrictions will apply to freestanding imaging centers as well. CMS intends to tighten the reassignment rule by restricting physicians from billing globally for, for example, an imaging procedure, and paying the provider, for example the contracted radiologist, a fee. CMS also intends to invoke the anti-markup provision that would make it illegal to bill the agency for anything higher than the amount for which the physician performs the specified service. If the rule goes through as written, many arrangements between radiologists and imaging technology-owning referrers will need to be restructured. Additionally, the rule proposes to limit the number of IDTFs that any one physician can oversee to a maximum of three. Finally, the rule proposes to prohibit marketing an IDTF to consumers. Because the new reassignment rule could present problems for radiologists who contract with nighthawk teleradiology companies, CMS specifically called for radiology to submit comments.

click here to submit comments >>

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Proposed MPFS Changes Take Aim at Self-Referral, IDTFs

More Than Donuts and Cappuccino

If CMS institutes the ban on advertising for independent diagnostic testing facilities, it will apply to consumer programs only and not the mainstay of most radiology marketing programs, referring-physician marketing strategies. Marketing means being a better communicator, and that process extends to referring physicians, their office staff, payors, your center employees and administrative staff, and the practice partners, in addition to your customers, as articulated last month by Curtis Kauffman-Pickelle, CEO of The Imaging Center Institute (Irvine, Calif) and CEO and managing director of Practice Builders (Irvine, Calif), during a presentation in Annapolis, Md, at the Outpatient Imaging Center Blueprint for Success conference, sponsored by General Electric Medical Systems. As Kauffman-Pickelle pointed out, the marketing mix is “more than donuts and cappuccino.”

The imaging center marketing arsenal includes market research, sales efforts by practice liaisons and radiologists, collateral materials, event marketing, advertising, e-marketing, promotions, and publicity that positions your operation as the health care expert.

“Marketing for radiology practices
is a lifestyle, not a band-aid.”

—Curtis Kauffman-Pickelle

Kauffman-Pickelle told the attendees that marketing is a core strategy for growth and success, and it all begins with developing your brand. To arrive at a brand, start with a clear point of view on what the organization stands for and how it will deliver a competitive advantage. All visual and verbal elements of branding should then symbolize that difference and aim to impress it in each customer’s mind.

Kauffman-Pickelle recommends applying the seven “Ps” of marketing to all marketing efforts:

Product (you and your report): What does it say? What does it look like? Does it reflect your brand?

Price: This will be increasingly important in the patient-choice model of health care.

Promotion: Trinket marketing is a visual opportunity to reinforce your brand.

Positioning: What is your position: convenience, low-cost provider, technology leader, subspecialty reads, or service?

Packaging: The presentation counts.

People: Everyone is a marketing representative, so brand the courier, uniform your staff, and make use of identification badges to extend your brand.

Place: Remember that people judge what they cannot see by what they can see. Because they rarely see the radiologist, how will you visualize quality for your customers?

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Imaging Center Institute Marketing Communications Services

RBMA Announces Quest Award Winners

3T MRI: You Have the Power, But What About the Patients?

America's Busiest Imaging Center

MSK Imaging:
Nowhere to Go But Up

Because orthopedic surgeons are a primary referral source for imaging centers, this source can be expected grow in importance as the percentage of the population exceeding age 65 continues to escalate. Orthopedic referrers are a key source of MRI referrals due to its ability to visualize the shoulder for rotator cuff tears, the hip for occult fractures, the knee for meniscal tear and insufficiency fractures, and the ankle for tendinosis and tendon tears. Orthopedic surgeons likewise, are an important source of CT referrals. “CT is used much less frequently, but it is most useful for fractures, for looking at the positioning of devices, and in the angulation of fractures,” Stephen J. Pomeranz, MD, CEO and medical director of ProScan Imaging, Cincinnati, recently told a writer for Imaging Economics. “So, CT still plays an important role in musculoskeletal care.”

But as orthopedic practices install MRI and CT scanners in their own offices, they are pulling the technical component away from imaging centers, leaving radiology practices to debate the wisdom of cutting their losses and taking the professional component or drawing a line in the sand. Meanwhile, an increasing number of teleradiology companies specializing in MSK imaging are stepping into the breach. This is a critical time for local radiology. Practices must beef up their MSK subspecialty expertise, or risk losing this important source of referrals.

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My Aching Back: The Impending Boom in Musculoskeletal Radiology

Global MRI Market Expected to Top $4 Billion by 2010