Imaging Healthcare Specialists (“IHS”), a 30-radiologist practice based in San Diego, California, has a simple ethos driving its business decisions. “We view ourselves, first and foremost, as a medical practice,” Thomas Cleary, president and COO of Imaging Health- care Specialists, explains. “Every day, every employee who works for us is making an impact on patients’ lives.”
Cleary’s philosophy of care involves attention to three key tenets of patient satisfaction. “We make sure we address the three needs of the patient,” he says. “When patients are coming to you, it’s not because they woke up that morning and thought they would get an MRI. They have an immediate medical concern, a financial concern as a result of the treatment plan, and a spiritual side that may or may not be affected by the first two.”
The IHS philosophy of patient care makes it a natural fit for accountable-care organizations (ACOs), which have been springing up in San Diego since the passage of the Patient Protection and Affordable Care Act (PPACA). “We are working to position ourselves as a specialty provider for these ACOs,” Cleary says. “At the end of the day, that means we need the ability to provide excellent care under a capitated payment arrangement.”
Efficiency has always been important to the group, Cleary says—which is why, nine years ago, it entered into a relationship with Zotec Partners, enabling the company to take over billing for IHS. “We decided our core business was imaging,” he recalls. “Accounts receivable should be someone else’s business.” IHS currently staffs two hospitals—one a tertiary-care facility and the other a community hospital—and operates 10 outpatient imaging centers in San Diego County. “We’re always trying to become more economical, to deploy more efficient technologies, each year, than the year before,” Cleary says.
The group’s relationship with Zotec has evolved accordingly, and today, it is about much more than back-office efficiency. As IT capabilities advanced, IHS began feeding information from its PACS platform into a business-intelligence software module developed and maintained by Zotec. “All of our information is fed to them, and we use it to look at our services in the inpatient and outpatient environments, in the emergency department, by payor, by patient, and by employer,” Cleary says.
For instance, Cleary says, IHS uses a night-hawk service for some of its night and weekend hospital staffing, but business intelligence enabled the practice to conduct its staffing more efficiently. “We use our night-hawk service for fewer hours than we did two or three years ago,” he says. “Using the Zotec system makes us more productive and more efficient.”
Positioning for Post-PPACA Business
Business intelligence has become particularly vital to survival in the post-PPACA era, Cleary observes. “With the changes in health care and payment that are happening now (and will happen for the next several years), we have to understand our business to the best of our ability,” he says. “We have to demonstrate that we are having positive outcomes, if we want to continue our business.”
With Zotec and other informatics solutions in place, Cleary says, IHS feels prepared for participating in an accountable era in health care. “Business intelligence gives us the ability to understand exactly what we can expect to be paid in a capitation model—and then, to determine whether we can deliver those services for less than that amount.” As a result of this modeling capability, he adds, “We’re performing profitably with several capitation arrangements in place right now—one for the inpatient practice and others for work done on an outpatient basis.”
Looking forward, Cleary says, IHS is hoping to grow its market share by 5% to 10% over the next three to five years. “Under the PPACA, there’s a large portion of the population in San Diego that will now have some kind of insurance, and if those people have insurance, there will be some kind of compensation for us,” he says. “Of course, we are physician owned, and one of the ways we think we can gain market share is that we make being a medical practice our first priority.”
That means maintaining the high patient-care standard that the practice has established, in spite of the reimbursement vagaries that it has already endured (as well as those to come). “We take care of the whole patient,” Cleary says, “and Zotec is one of our partners in making