Eisenhower Radiology Medical Group (ERMG) has accomplished what many would consider impossible: rapid, recent expansion during a recession, with a patient base composed primarily of Medicare beneficiaries. The 17-radiologist group, located in Rancho Mirage, California, has added three imaging centers to its roster in as many years, according to Blair Dick, business administrator for the practice. “One of the biggest challenges we’ve faced was expanding from one facility to four in this economic environment, which is one of the worst we’ve ever faced,” Dick says. “We did it because we wanted to position ourselves to accommodate the increased demand for imaging services that will result from health-care reform.”

The proposed 2014 Medicare Physician Fee Schedule1 (MPFS) and Hospital Outpatient Prospective Payment System2 (HOPPS) rules have both been released, and the outlook for radiology is dim, according to Cynthia Moran, assistant executive director for government relations and economics at the ACR®. “The only good news—if you can call it that—is that CMS no longer appears to be targeting only radiology,” Moran says. “It used to be that it was seeking to take from the specialties and give back to primary care, but now, it’s not even doing that. It’s just lowering how much money is spent as much as it can.”

Radiology-practice consolidation has become more than just a trend: It’s an imperative for future survival, according to Michael Brant-Zawadzki, MD, Ron and Sandi Simon endowed executive medical director chair at the Hoag Neurosciences Institute (Newport Beach, California). “Scale is becoming much more important,” he notes. “Smaller groups are looking for help and are being overtaken by corporate entities like national teleradiology groups—or by larger, independent group practices. Under that model, they can distribute subspecialty services more efficiently and can realize economies of scale.”

Big data, as a term, means different things to different industries and professionals, but loosely defined, it refers to the explosion of information flowing into and out of businesses—including medical practices—over the past few years. Of the world’s data, 90% were created in the past two years alone; IBM estimates that 2.5 quintillion bytes of data are generated every day.

Jeff Maze has spent his career attempting to solve the conundrum at the core of business intelligence and analytics: the more data there is, the harder it is for operational leaders to understand and act upon. “Everyone has data. This is the era of big data,” Maze, who is senior manager of business intelligence at Zotec Partners, says. “But data does not mean the same thing as information. The key is taking data and making it timely and actionable, baking your own insight and experience into it, and turning it into wisdom.”

Radiology’s business environment has changed considerably since the heyday of the late 1990s and early 2000s, when the equation for success was comparatively simple, Paul Staveteig, MD, says. “Now, the environment is different,” he explains. “The only way to survive in this marketplace
is to be able to look at things very critically and make decisions very quickly.”

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.”

Medical practices have arrived at a juncture where the importance of business intelligence to strategic planning and growth cannot be ignored, says Scott Law, founder and CEO of Zotec Partners. “Physicians are, first and foremost, scientists, and historically they have focused on the science of their discipline as opposed to the business side of medicine,” he says. “In the current environment of evolving health care delivery and reimbursement models, the key to survival is finding ways to differentiate yourself—not only through productivity and efficiency, but also through quality and improved outcomes, which we are really beginning to be able to measure for the first time.”