Imaging Center Roundtable, part 2

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More from the Imaging Center Roundtable, with nurse navigators, integrated women's imaging, patient-centric marketing and more after the jump! Q: What is the role of the breast care specialist/navigator in women’s imaging? A: We just started this. We have two certified nurse navigators, and it’s been phenomenal so far. I can’t say enough good things about it. The response from patients is three pages. We’re an outpatient imaging center, and the nurse navigator takes the patient by the hand and explains all the procedures beginning with the biopsy. And they’re just someone to call. They’re the guidance. Especially in this area of women’s health, these physicians aren’t always communicating with each other, so the nurse navigator is the one in the middle tying all the links together. But it has to be someone who can sit with the patient for two hours discussing this with them. It can’t just be anyone. A: We also have a breast imaging center and we do something very similar, except we do it with our referring physicians and breast surgeons in the area. The report is back to the referring physician within an hour and we coordinate all her care within our facility. Now we’re averaging about a 10% increase per year, mammography-wise. Moderator: Is anyone here moving in the direction of integrating their practice with an oncologist or radiation therapist? A: We started an integrated women’s imaging center about two years ago. One of the pushbacks in our community is that the oncologist wanted to be there meeting the newly diagnosed patient instead of the surgeon. Everyone wants to be there when the patient is told bad news. I don’t know if any of you have a suggestion. The oncologists are suddenly realizing that they’re losing out to other oncology groups. As you build your team to work with the newly diagnosed patient, you’re going to see some of those politics. There’s a vast difference between the surgeons and oncologists on who should be first to consult the patients. Q: What are some creative marketing ideas for patients regarding the importance of the radiologist’s role? A: What I heard at the last roundtable was that many practices don’t want to get in between the referring physician relationship and the patient. It’s a bit of a controversy to say to the patient via some campaign that the referring physician has no idea what he’s doing and here’s a better option. But some groups have had some success with elevating the idea of the radiologist as an important, fellowship-trained part of the care continuum. But it is somewhat of a controversy if you already have strong referring physician relationships. You’re messing with a delicate balance. Moderator: I’ve chosen to mess with it. I’m going to present with a partner from the ACR in November on marketing to patients. Some practical aspects related to this concept, I recently hired a facilitator at our imaging center and we conducted focus groups with patients. The first question was, “Define the role of the radiologist,” and the second was “What is your relationship with the radiologist?” And the words they used to the second one made me take notice. They basically said there is no radiologist. It’s anonymous and detached. Two people used the analogy of the Wizard of Oz. They proposed that some level of interaction would really change their view. Bottom line, they said the radiologist is the doctor’s doctor more than my doctor. A: One of the things we did is any abnormal results, the radiologist delivers the results directly to the patient in their office. It doesn’t take that long, and we saw a great amount of success. A: Getting the radiologist out of the room is ideal and wonderful, but they picked this role as a physician for a reason. They chose this path. Moderator: Another approach I’ve mentioned is that most communities have public access networks. We’ve partnered with them and are sponsoring health talks with a celebrity. We pair up a radiologist with a member of the medical community. It’s not formal, it’s not stuffy, it’s very relaxed. I can’t tell you the amount of positive feedback we’ve received. People finally see them as human. And it only costs about $250 per episode. It’s not cost prohibitive. Q: What are the key differences between an IDTF and an imaging center designated as a physician’s office? A: The differences are stark. The IDTF has much greater reporting requirements when it comes to Medicare. We have to get inspected. There are limitations, certain things we cannot do, like biopsies. There are things we can’t do from a marketing standpoint. They’re pretty stark. From an IDTF standpoint, we like the concept of everyone else having to play by the IDTF rules. It makes sense to us. Q: What is being anticipated within ACR and RBMA for imaging centers? Moderator: Lower reimbursement. More pressure. More challenges. As our opening session speakers on both days have said, we’re also in the position to identify opportunities. We’re going to continue to face challenges, and we’re going to need to make some adjustments. At the last session I asked a gentleman if he thought there’d be a resurgence of IPAs. Anyone think it’s going to happen? He didn’t. Q: Any known issues to affect the PC billing for imaging centers? Moderator: With precerts and preauths on the professional side, without the correct number, you’re not going to get paid. A: We’ve had some success in Washington negotiating with the payors to pay us when the hospital gets denied, because we have no control over that. I would encourage anyone who’s in contract negotiations to pursue that. It can be done.