The Old New
Competitive Weapon
By Curtis Kauffman-Pickelle

It was sometime during the spring of 1985 when I had the chance to meet in Boston with the person who coined the term CIO. Bill Sinnott was at the time was one of the only Chief Information Officers in the country and from his vantage point at the Bank of Boston he had written an intriguing book on the subject. I had the opportunity to interview Bill for a business journal I published that was devoted to that emerging audience, and recall that his prediction at the time was that information would eventually become the ultimate competitive weapon

How true that notion has become in the ensuing years.

Fast forward to the current business climate and in outpatient imaging we find ourselves in the midst of an incredibly competitive and complex marketplace, becoming more so each day. Lately I have been thinking about Bill’s prediction and how it applies to our radiology world and guess what? The one thing that will ultimately contribute to the success of your radiology practice or imaging center is how you use information as your ultimate competitive weapon. Although this sounds new to some, it has to do more with radiology’s time in the cycle of application of business innovations.

read more >>

Financing Challenges
for the Post-DRA Era
By Gordon Baltzer

The pending implementation of the DRA reimbursements cuts has been looming over the diagnostic imaging industry for the past year. Although there has been hope for a fourth quarter moratorium on the implementation on these cuts, we encourage all those to be effected to manage their business planning under the assumption that the DRA cuts will be implemented.

The major impact on the financing of equipment replacement projects or the development of new diagnostic centers really boils down to patient volumes. In the past, many projects that obtained lease- or debt-based financing, reflected slow and gradual growth periods with the usual factors being cited for the projected ramp-up. The business plans almost always include: better quality images, faster report turn-around times, a better patient experience, and the hiring of the best marketer in the industry. While these factors are always an essential element of the proposed business plan, on their own, they are simply not enough anymore. A major effort in the new reduced-reimbursement era must be made on proving patient referral patterns and the relationships with the physicians that exert control on those referral patterns.

read more>>

The CRO:
On Reimbursement Watch
By Dan Heibert

Sometimes I joke with people who ask me what I do for a living. “I am a crow,” I reply. I recently joined the administrative team of Inland Imaging in Spokane, Washington, and fill a slightly different and (hopefully) value-added role for the company. While most Spokanites have heard of Inland Imaging and many industry insiders across the country know Inland for its progressive use of technology, most are unfamiliar with the title CRO, which is the acronym for chief reimbursement officer.

This emerging position in the large medical practice was born out of the observation that the business office holds many keys to the organization’s financial success. Effective health plan contract negotiations, maximally correct coding (not to be confused with up-coding), efficient back-office operations, and, of significant importance, comprehensive data analysis with clinical and financial relevance—increasingly referred to as informatics—are all critical to the success of a practice.

read more>>

The Case for Emergency Responder Magnet Safety, Part I
By Nicole Pliner, MHSA, and
Frank Panzarella, MHSA, CHE

You run a sound MRI operation with employees well trained in magnet safety, but have you ever thought about the scene following a fire alarm being pulled? Imagine several imposing, fully geared firefighters bursting through the door unabated, wielding axes, and completely unaware of the invisible danger generated by your MRI scanner. Why is this important? Because there has been a proliferation of MRI scanner sites in hospitals, commercial buildings, off-site clinics, mobile imaging trailers, and even unconventional sites such as shopping malls. Proactively training external emergency response personnel is not just a nice community service to provide, but a prudent business investment as well.

read more >>

Will RFA Migrate to the
Outpatient Setting?

Alongside chemotherapy and radiation therapy, radiofrequency ablation is emerging as an important tool in the armamentarium of cancer treatments when surgery is contraindicated, most commonly in the liver and, on an investigative basis, the lung.

While the incidence of hepatocellular carcinoma (HCC) is estimated to account for 6% of all human cancers worldwide, more than 75% of patients are unresectable at the time of diagnosis. With the incidence of HCC rising in the United States, ACRIN Protocol 6673, still open and accruing patients, is investigating outcomes for patients with cirrhosis and HCC in whom surgical resection is contraindicated. The goal is to estimate the proportion of participants undergoing solitary or repetitive RFA treatment sessions whose livers have no identifiable tumor by CT scan at 18 months following initiation of therapy.

The economics are still emerging, according to RFA pioneer Damien Dupuy, MD, Rhode Island Hospital, profiled in the October issue of Imaging Economics. “We did an ROI [return on investment] and found that RFA breaks even,” he told a reporter, adding that the RFA program “creates considerable downstream revenue, because if you attract that cancer patient [through RFA], then all the follow-up increases the hospital’s revenue.”

Also interviewed was Stephen Hiss, director of diagnostic imaging at Rhode Island Hospital, who shares that payors are still reluctant to reimburse, and even Medicare, one of the better payors for this service, can be difficult.

“That’s the universal problem in health care today. It’s a classic balance between payors holding costs down and, at the same time, a new service coming on line that threatens the holding of that line. It’s a difficult process.”

— Stephen Hiss, director of diagnostic imaging,
Rhode Island Hospital

Another issue is freeing up valuable time on the CT scanner so that the interventional oncologist can perform the RFA. However, Dupuy predicts that RFA will become the standard of care, and the procedure is already beginning to migrate to the outpatient setting.

read more >>

RFA: Cancer Care’s Fourth Arm

Interventional Oncology: How to Set Up a Service

Squeezing Blood from a Turnip

There are several reasons to offer mammography in a freestanding imaging center, although profits are not usually one of them. Mammography brings decision-makers—women—to the center and many payors are beginning to demand a full range of imaging services from a site before letting it into their networks. And while many practices dismiss mammography as a loss leader, with close attention to billing and collections, providers can maximize breast imaging revenue, according to Lawrence W. Bassett, MD, professor and director of the Iris Cantor breast center at UCLA, who presented at the recent Society for Breast Imaging meeting in Las Vegas.

read more >>

Achieving the Improbable