When the hospital is the buying party in an imaging joint venture, there are four potential issues that could terminate the transaction, all of which stem from due diligence. These issues include one or both parties failing to understand the distinction between fair market value and strategic value, conflicts surrounding how professional payments are determined after the transaction, collection irregularities or other problems with revenue recognition, and management and governance issues for the newly joint-ventured or acquired imaging center. All four of these transaction deal-breakers, however, can be avoided through understanding, preparation, commitment to communication, and setting expectations.

Here’s a confession: Though a bit of a snob about most of what’s on television these days, I’m obsessed with AMC’s “Mad Men.” I’ve watched every episode more than once, analyzing each for hidden meanings and recurring themes; I even read recaps online in case there’s anything I missed. An oft-repeated truism on the show, trotted out when its ad executives are dealing with clients in difficult situations, is: If you don’t like what’s being said, change the conversation. I wonder, sometimes, what the creative geniuses of the fictional ad agencies of “Mad Men” would make of imaging’s biggest current problem.

Radiology groups’ conversations with their hospital partners are undergoing an evolution, in the experience of Edward Rittweger, MD, president of Navesink Radiology (Red Bank, New Jersey). “In the past, most of the hospital discussions involving imaging have been about decreasing turnaround times and increasing efficiency in response to decreased reimbursements,” he says. “As we move forward, however, it will be more important for the radiology group to assist the hospital in developing metrics to evaluate how imaging adheres to decision-support mechanisms and evidence-based care protocols.”

All over the country, radiology practices are merging, consolidating, and forming networks in order to grow in size and, in theory, negotiate from a more powerful position while making the most of economies of scale. Tom Vaughan, MD, president of Kent Diagnostic Radiology Associates (Dover, Delaware), points out that the emphasis on growth raises some challenging questions, from a practice-management perspective. He says, “As you grow from being a small practice to being a large one, management becomes much more challenging. In some ways, it can be a luxury to be small.”

Clinical analytics for radiology can play a critical strategic role in practice development and growth, but only if the approach to aggregating and sharing analytics is effective, according to Paul Potok, DO, radiologist and board member with Quantum Imaging & Therapeutic Associates, Inc (Lewisberry, Pennsylvania), a 40-radiologist practice. “Many of the metrics we track are the same ones people have been tracking for years, but we do it differently,” Potok says. “Among other things, we make the information instantly accessible to everyone.”

In the last issue of RadAnalytics, I wrote about productivity and efficiency, with an emphasis on keeping an eye to quality. I believe that those group practices that figure out the key to improving individual radiologists’ productivity (as well as overall group productivity) while adhering to patient-centered quality objectives will thrive under the new collaborative reimbursement models that we are seeing in the market.

Hackensack University Medical Center (HUMC) in Bergen County, NJ, and Mount Desert Island Hospital in Bar Harbor, Maine, won for their excellence on multiple levels and superior patient care

An American Society of Nuclear Cardiology (ASNC) official spoke in favor of appropriate use criteria to reduce inappropriate cardiac imaging in his testimony to the U.S. House Ways and Means Health Subcommittee