Like most radiology practices nationwide, Pueblo Radiology Medical Group, based in Santa Barbara, California, is facing the imperative to do business differently than in the past. Wayne Baldwin, CEO of the 18-radiologist practice, attributes the shift to changes in the regulatory environment that have made today’s radiology marketplace anything but “business as usual.”

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 Partners, 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.”

If you work in radiology group practice, it’s likely you are considering your market position and evaluating whether you should be growing—if you haven’t expanded already. Depth of subspecialization, round-the-clock service and economies of scale are all necessities for imaging in markets experiencing consolidation. In short, if your hospital and health system customers are increasing in size, you should be as well.

UnityPoint Health, formerly Iowa Healthcare, a multi-city integrated delivery system based in Des Moines, recently underwent a transformation aimed at empowering primary care physicians to take the lead in care coordination for patients.

Even in the wake of health care reform, radiology practices continue to struggle with managing payment from uninsured patients. The problem plagues hospital-based groups, in particular, according to Krista Pelensky, director of operations with Zotec-MMP. “Many hospital-based groups have seen an uptick in uninsured business and an increase in emergency-department services,” she says.

Few business processes for radiology practices are as fraught as negotiating managed-care contracts. Their duration and durability put a significant level of both current and future income on the line, but small and medium-sized practices, in particular, might feel that they have little leverage in the negotiating process. The keys to gaining the

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.