| Many
large practices have seen the benefit of spinning off
a business services unit, but not many, we suspect,
would anticipate a valuation of $62.5 million. That
is what St Paul Radiology realized in the recent sale
of its business services unit to NightHawk Radiology
Services, Coeur D’Alene. In exchange, NightHawk
gets more than a major client for its Talon workflow
application and new business services division. It acquires
a full suite of business services for cross-selling
to its 700 customers, 100 experienced employees, and,
now that it has billing capability, easy entrée
into the business of final reads.
“We look at this as continuing to the lead the
professional transformation of the practice of radiology,
said Paul Berger, MD, NightHawk CEO, in an investor’s
conference call on July 17. “And this is an opportunity
to expand the services that we are able to offer our
customers. From a financial perspective, it is very
attractive, but this is also an opportunity to offer
these services to a customer base that is 700 and growing.
We are hearing from our existing customers that this
is something they would like us to do.”
Tim Mayleben, NightHawk executive vice president and
COO, reported that Nighthawk paid $62.5 million in cash,
along with a 300,000-share warrant on NightHawk common
stock. Financing came from a $100 million 7-year term
loan syndicated through Morgan Stanley senior funding.
According to Mayleben, the company has drawn on that
$100 million facility to fund both the RadLink acquisition,
announced in April for $53 million, and the $62.5 million
for the current acquisition. The company also kicked
in $20 million of its own cash.
Berger described St Paul Radiology to his investors
as one of the country’s largest and most progressive
radiology groups, with approximately 90 physicians serving
more than 40 hospitals and imaging centers. Through
the acquisition of the practice’s business services
unit, NightHawk will offer revenue cycle management
HR facilities services, accounting and financial services,
transcription services, records management operation
support, and quality assurance program support.
According to Mayleben, the plan is to offer a variable
rate plan depending on what services a client needs.
“We in general are talking about providing a complete
suite for our radiology customers, so if a customer
just wants revenue cycle management—the traditional
billing, collecting, coding—then the 5 to 8% range
is the number,” he told investors. “For
the broader suite of services, we think the market is
probably going to be quite a bit higher than that.”
Berger speculated that 85-90% of radiology practices
outsource a significant share of their business solutions.
“We will benefit from the increasing imaging demands
placed on our customers,” Berger told investors.
“As our customers’ businesses grow, so does
ours because of our percentage of revenue business model.
As you can tell, we are very excited about this acquisition
from both the strategic and financial perspectives.”
Berger, who continues to be a working radiologist, told
ImagingBiz.com that NightHawk has focused on how to
help radiologists from the outset. “The low-hanging
fruit was the nighttime and off-hours coverage, and
that was clearly perceived—was, is, and, I think,
forever will be—as a help to radiologists,”
he notes. “The adoption is evidence that it has
been very well received.”
The purchase of St Paul’s business services represents
a continuation of that ethic. “As a radiologist,
I personally believe we need to focus on efficiency
because if there are, and I hope there are not, but
if there are any kind of pricing trends, pressures,
or reimbursement cuts, one way to help mitigate that
is to become more efficient in what we do and the way
that we do it. So we want to be able to help the radiologist
become more efficient….I was the head of a large
group in California, and I knew what we had, and I want
to make those things available to everybody.”
Berger dismissed the suggestion that NightHawk is building
a national radiology practice. “We’re not
a radiology practice at all, all of our radiologists
are independent contractors,” he stated. “That’s
not something we want to do. If it helps St Paul expand
its scope of operations and opportunities, that would
be up to them. We will never be a national radiology
group.”
St Paul Radiology CEO Mark Kleinschmidt will serve as
president of NightHawk’s new business services
division, and, at press time, it was unclear who his
successor would be at the practice.
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