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.

When Peoria, Illinois-based OSF HealthCare transitioned from analog to digital imaging, one aspect of the radiology continuum proved challenging: quality assurance. “We had a fairly robust, paper-based QA process when we were film and paper,” recalls Tom Cox, director of radiology at OSF Saint Francis Medical Center (SFMC). “When we went to PACS and went paperless, however, we virtually stopped getting feedback from the radiologists on quality. We knew we needed something to replace the paper process.”

Radiologists and hospital administrators are finding common ground when it comes to one significant conundrum, according to Richard Duszak, MD, CEO of the ACR’s Harvey Neiman Health Policy Institute. “We are moving from a system where we got paid for doing procedures to one where we will get paid for taking care of patients,” Duszak said in a presentation at the 2013 conference of AHRA: The Association for Medical Imaging Management, held July 28-31 in Minneapolis, Minnesota. “The big word is value, and it’s going to be a real challenge for physicians and hospital administrators.”

Continuous improvement is an oft-repeated catchphrase, but achieving it while maintaining or even ramping up efficiency can be difficult. That was the dilemma faced by Tacoma, Washington-based MultiCare Health System (MHS) in 2009. “We wanted to be able to close the loop on our quality assurance, getting the results of review back to the individual radiologist for his or her input,” recalls Andrew Levine, MD, Chair of the Executive Committee at Medical Imaging Northwest, one of three radiology groups serving the health system. “We needed a system that was integrated into the PACS so the radiologists wouldn’t have to go find a piece of paper and fill it out, interrupting their workflow.”

As accountability in health care becomes an increasingly critical priority, many anticipate a future in which radiologists are employed by hospitals attempting to share risk and align incentives. Accountability can be achieved without employment, however, according to Carl Black, MD, of Utah Radiology Associates (URA), Orem/Provo, a 24-physician practice covering five hospital systems, including the oft-lauded Intermountain Healthcare (Orem). The practice’s relationship with Intermountain Healthcare was the subject of a presentation made by Black on July 28, 2013, in Minneapolis, Minnesota, at the annual meeting of the AHRA