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 Healthcare Specialists, explains. “Every day, every employee who works for us—from the person who schedules the patient, to the technologist who provides the exam, and from the radiologist delivering the report to the IT person—is making an impact on patients’ lives.”

The most common misconception regarding medical-practice reimbursement is that it’s about nothing more than money. In fact, reimbursement is about much more than the dollar numbers associated with CPT® codes in payors’ various fee schedules, and any discussion of it that doesn’t also touch on process, strategy, and service is incomplete.

Many radiology practices, by now, have been persuaded of the importance of deeper alignment and integration with their hospitals and health systems. Jana Landreth, director of practice management for Zotec-MMP, says, “If your hospital approaches you wanting this, you need to embrace it. Going into this with reluctance or hesitation will not move your relationship forward, and the odds are that you will wind up doing it eventually anyway. If you embrace it now, you will be able to set the goals with the hospital and make them realistic for what your practice can achieve.”

Inverness Medical Imaging (Inverness, Florida) had an especially strong motivation to apply for federal meaningful-use incentives: With a payor mix that was 60% Medicare, the radiology practice knew that the eventual penalties for not attesting to meaningful use would be too big a hit to sustain. John Erler, administrator, says, “The incentives are good, but if you aren’t meaningful-use compliant, the government will eventually reduce your reimbursement through Medicare. That’s a huge portion of our business, so it made sense for us to get onboard now and get as much of the incentive money as possible.”

The standard of value must be established in performing a valuation of any imaging business. The standard of value defines the hypothetical conditions under which a valuation will be performed. These hypothetical conditions affect many of the underlying assumptions that an appraiser or valuator would employ in establishing a value opinion.

At the 2013 annual meeting of the AHRA, held in Minneapolis, Minnesota, Chad Calendine, MD, CMO of Optimal Radiology Partners, presented “Radiologist As the Chief Marketing Officer” on July 28. The focus of his session was how radiology groups can enhance their value and visibility to the rest of the health-care continuum; Calendine believes that radiologists should more aggressively market themselves to stakeholders ranging from patients and referring clinicians to hospital administration.

Any community under duress is likely to find itself plagued by disagreements, infighting, and polemicizing. It’s a normal response to a difficult situation—especially one in which there are no easy answers to the challenges being faced. I think of this each time that I attend management-focused meetings (such as those of the AHRA or the RBMA) in which nonclinician businesspeople point to radiologists as the source of imaging’s current problems; at clinical conferences, physician thought leaders cite the increased focus on business-based priorities, such as productivity and efficiency, as the real issue.

Despite increased oversight, declining reimbursements, and other broadsides that have hit medical imaging over the past few years, growth opportunities are available. One commonly overlooked source of scan volume and the resulting revenue is the lien patient.