Radiology practices have long sought a solution to the consolidation occurring in their marketplaces, as well as the commoditization happening in their midst. The fundamental problem is delivering ever-higher levels of service and quality with diminished resources. “As an independent physician and radiology provider, I feel very strongly that an autonomous radiology practice is the best way to provide good patient care,” says Thomas Yu, MD, medical director at Advanced Radiology Solutions (Toms River, NJ). “We’re not responsible to shareholders, or a hedge fund, or a large corporation—we’re focused on our patients, our hospital partners and our community.”
Unsurprisingly, other similarly positioned radiology practices in the New Jersey area felt the same way. “In our state we have a lot of small radiology groups under a lot of market pressure to get bigger,” explains Ed Rittweger, MD, medical director at Navesink Radiology (Little Silver, NJ). “Hospitals are looking for 24/7 subspecialty reads and other services you might not be able to provide as a smaller group.”
And that’s not all they’re looking for, notes Leo Fontana, MD, radiologist at Navesink. “One small radiology group might not have the critical mass necessary to get powerful data and analytics,” he says. “Radiology needs to deliver those to its partners to help develop and shape new reimbursement and practice models. We have to position ourselves to be proactive partners.” Alicia Daniels, MD, radiologist at Advanced Radiology Solutions, concurs: “Every time we go to a meeting with the hospital it is always all about data,” she says. “We know we need to be able to deliver.”
Edward Rittweger MD, Thomas Yu MD, Leo Fontana MD, and Alicia Daniels, MD come together to discuss a new kind of joint venture.
Hiding in Plain Sight
Rittweger describes the solution at which the groups arrived as “a fairly simple concept that was hiding in plain sight”: instead of competing against one another as small entities, what if they joined together in a JV alliance? “We were all looking to maintain our independence while getting the advantages of being a larger group,” Fontana says. “If you join a larger group, you can lose a lot of your autonomy. This alliance was a way to get the best of both worlds.”
Not only is this approach best for the groups, it’s also best for their customers, Yu says. “A lot of these big box companies don’t provide the leadership they say they will be able to,” he notes. “They lose contracts as fast as they can get them, and in the process they cause a lot of disruption—it’s like musical chairs. Corporate consolidation has been a detriment to the field so far, but if radiology practices work together, we can provide the resources and leadership that our hospital partners need.”
By collaborating instead of competing, the groups have the combined capital for necessary new investments; they can provide managed services to other groups, opening up a new revenue stream while helping preserve the profession; and they can harness the data and produce the analytics that will be so vital to future survival. “The alliance provides the resources to build the analytics platform we’re going to need,” Rittweger says.
Measuring to Grow
Of the many reasons for aligning through a JV/alliance model, the one all the practices mention most often is data—having enough of it, and being able to do enough with it. “Data is the new currency,” Fontana says. “In the future, volume won’t matter—what will count will be how we measure and demonstrate our value.”
For that reason, Yu says, analytics are built right into the alliance’s DNA. “We have to create analytics that go beyond the basics to drive what we do, our behavior and the behavior of our colleagues,” he says. “We have to provide best practices, reduce unnecessary utilization and increase diagnostic value. Working with our partners using real-time clinical information will allow us to continuously improve our quality.”
For instance, Fontana says, the groups will be able to utilize their own data to improve the position of their hospital and health system partners, thereby mitigating the threat of competition from commercial radiology practices. “As part of our hospital contracts we have an appendix with certain deliverables, most of which are measurable,” he says. “We’ll collect analytics on those so that we know how we’re doing on a near-real-time basis with meeting those parameters and can take corrective action as needed.