This article is the second in a four-part series. To read the first article, click here.
Radiology practices trying to prioritize their IT investments must consider the needs of multiple constituencies in order to make smart decisions. While the needs of referrers—and increasingly, patients—are important, the practice must also look at its own internal technology needs to make investments that serve its strategic goals. In today’s radiology market, that technology must provide the practice with an on-demand snapshot of its performance and enable it to benchmark that performance against itself and against similar practices to establish targets, according to Neal Peterson, director of client development for Medical Management Professionals (MMP).
“When radiology groups were making money hand over fist and could not lose, no matter what, decision making was a looser process,” Peterson says. “The climate, especially the downward pressure on reimbursement, is the reason that practice technology is so much more important now. All the radiologists want the practice to have this technology, and they want to have access to it.”
Dashboarding and Benchmarking
Practice-management technology would, ideally, offer radiology groups three levels of data, according to Peterson. He describes dashboards, the first level, as a transparent window into the billing operation: “Your dashboarding is going to provide topical, day-to-day, key performance indicators,” he says. “It will reveal whether someone is only running charges on the last five days of every month, or whether there is a coding lag. It is not for the radiologist partner to micromanage, but it offers some comfort that the group is on track, at any given point in time.”
Next, Peterson says, is the level at which benchmarking occurs. Data points to benchmark include productivity levels, volumes/procedure counts, charges, reimbursements, and RVUs; practices should compare these measurements with their own performance in the previous year. “Everyone wants to think that the best way to benchmark is against other groups like yours, but the most important thing is to benchmark against yourself,” he notes. “No one else has the exact challenges, payor mix, modality mix, or hospital systems you have. Quickly benchmarking where you are now against where you were last year gives you insight into how your practice is doing.”
Benchmarking against other practices can be useful as well, but is made more difficult by the scarcity of data. Nationwide billing providers such as MMP, Peterson notes, have access to the data from an array of practices, which can be anonymized and matched against the characteristics of a given group to yield useful information. “Local benchmarking will be your best because it shows the same payors and similar volume,” he says. “Reimbursement should be compared against your own practice, against other local practices, and against national benchmarks.”
He continues, “The national benchmarks are great for practices to see that their struggles with bundling, decreased reimbursement, and costs are not singular, and that everyone is experiencing similar pains. Your group may have taken a 3% hit for CT bundling, but looking across the country, that average could be closer to 6%, for many groups. National benchmarking is more of an exercise in perspective. ”
Radiologists are increasingly benchmarking themselves against their fellow physicians, within their practices. “This can become political, so you want to have the ability to blind the data,” Peterson says. For instance, looking at procedure volume might make one physician appear more productive than another, while RVUs might tell a different tale. “The information can be contentious. You may have a plain-film radiologist operating at 1,600 procedures a month, while an interventional radiologist is doing 200. When you convey that in RVUs, however, it is a different story,” he says.
Each group has to decide for itself how revealing it wants to be about radiologists’ performance, Peterson adds. “We often talk about transparency from a billing perspective, but there is also transparency within the practice to address: What is everyone doing in terms of productivity or reimbursement? That is a political issue within groups,” he says, “but when groups are using these data for compensation, it becomes very important to offer quick access to the data so physicians can know where they stand.”