Category: Imaging Centers

Better Radiologist Productivity with Clerical Assistants

Posted on by Brian Casey

What if there was a way to improve your radiologists’ productivity and help them focus on image interpretation without the heavy lift of a massive imaging IT project? Australian researchers found an old-school solution: shifting many clerical tasks to radiology administrative assistants.

The huge – and growing – disconnect between radiologist staffing and imaging volume has imaging managers around the world searching for solutions. 

  • Some are turning to high-tech tools like AI to squeeze more productivity from their radiologists, many of whom are already operating at maximum capacity. 

But lost in the debate is the reality that radiologists perform many functions besides just image interpretation (a fact that seems to have escaped some New York hospital CEOs).

  • These tasks include notifying clinicians of imaging findings, locating prior images, and study protocoling. Previous research indicates that these noninterpretive tasks can consume up to 44% of a radiologist’s workday. 

In the new study, published in Current Problems in Diagnostic Radiology, researchers implemented a system in which radiology administrative assistants were assigned to radiologists at Jones Radiology, a network of 60 radiologists across 30 sites in Australia. 

  • The RAAs worked normal business hours and were assigned tasks through a critical results feature in the PACS. Radiologists could choose if and when they wanted to use the RAA service. 

The main task RAAs handled was communicating critical results to referring physicians. 

  • But they also had other jobs, like finding and importing prior images, flagging scans that needed priority review, and providing research assistance. 

How well did the RAA system work? The researchers tracked its performance over 12 months from 2021 to 2022, finding that RAAs…

  • Were assigned 5.4k tasks during the study period.
  • Saved 679 hours of radiologist time.
  • 50% of the tasks involved communicating significant or unexpected results to clinicians.
  • The remaining tasks were unrelated to results communication, such as sourcing external images, miscellaneous tasks and general inquiries, and supporting radiologists with IT issues.  
  • Over 90% of “important” findings were communicated within the six-hour target turnaround time, but only 55% of “critical” findings met the one-hour turnaround goal.

The Takeaway

The idea of a clerical assistant to take over a radiologist’s noninterpretive tasks isn’t necessarily new, but this study is a great example of how to put it into practice. Radiology administrative assistants could also serve as a bridge to more complex IT-based operational solutions in the future.

PE Practice Purchases Tick Up

Posted on by Brian Casey

Private equity acquisitions of radiology practices ticked up in 2024 after two years of declines. A new paper in JACR sheds light on PE purchases in radiology, which have raised concerns about the corporatization of medical imaging in the U.S.

Private-sector radiology historically consisted of independent imaging practices run largely by radiologist-owners who contracted with hospitals to read imaging exams.

  • That model has begun to break down as radiology attracts investment from private equity investors eager to roll up what they see as a fragmented industry into larger companies that can leverage market power.

But what’s good for PE investors may not be good for radiologists – or for healthcare. 

  • Private equity investment in healthcare providers has raised concerns that investors may be putting profits before patients.

The new study documents the rate of private equity investment in radiology from 2013 to 2024, based on queries of the Pitchbook and CB Insights databases, finding …

  • There were 113 PE-led radiology acquisitions over the full study period (out of a total of 4.3k radiology practices in the U.S. in 2023). 
  • PE radiology acquisitions peaked at 18 in 2021, fell for the next two years, and ticked back up to 10 in 2024.
  • Most of the radiology practices being acquired employed 50-99 radiologists.
  • PE-led acquisitions were most common in the South.

So what’s to make of the numbers? A total of 113 acquisitions over 10 years isn’t that many (although the authors caution that acquisitions of multi-state or national practices and imaging chains would be counted as a single deal). 

  • And the researchers acknowledge that there’s little data on the impact of corporatization on healthcare quality, at least in radiology (although they do cite a study showing that PE ownership was associated with an 8.2% increase in radiology prices).  

The Takeaway

Private equity investment in radiology practices may still be in the early stages relative to other medical specialties, but radiologists will watch PE acquisitions closely for signs of how the trend may impact them. The new study serves as an important baseline for tracking future activity.   

RadNet’s Bellwether Briefing

Posted on by Jake Fishman

RadNet’s investor briefings have come to serve as a medical imaging industry bellwether, and last week’s Q2 call lived up to that reputation, providing key insights into how RadNet is approaching imaging’s biggest trends (and by proxy, where its hospital partners, competitors, and vendors are also likely focusing).

Here are some of the big takeaways…

Hospital system joint ventures remain core to RadNet’s strategy, as payors’ outpatient emphasis helped RadNet expand hospital JV agreements to 29% of its imaging centers (vs. 25% in 2021). It’s targeting 50% in the next 2-3 years.

RadNet acquired three imaging centers in 2022, but much of its short-term imaging center growth will likely come from the 15 net new locations that are under construction.

A long list of headwinds (reimbursements cuts, labor shortages, access to capital, recession) could lead to greater imaging center market consolidation, and RadNet believes it’s better equipped to take advantage of a downturn than its competitors. 

RadNet forecasts that the tight imaging center labor market is “here to stay” and “needs to be addressed with technology.” Following that advice, RadNet highlighted its efficiency-focused moves to adopt MRI DLIR software, launch a remote MRI technologist management solution, and transition its eRAD PACS to the cloud.

RadNet’s AI strategy remains focused on cancer detection / diagnosis leadership and it still views AI extremely optimistically, although the briefing served as a helpful reminder of how early we are in AI’s evolution:

  • Q2 AI revenues reached just $1.5M (that’s including Aidence & Quantib), while heavy investments led to a -$5.9M pre-tax loss for the AI division.
  • RadNet is rolling-out its DeepHealth mammography AI solution through Q4 2022 or Q1 2023, calling the implementation’s installation and training requirements a “tall task” (and they developed it…).
  • Nonetheless, RadNet is confident that the mammo AI solution will deliver immediate benefits to its team’s accuracy, productivity (up to 15-20%), and imaging center scan volumes.
  • RadNet also installed its ` prostate MRI solution at select imaging centers that perform prostate cancer screening, although its overall prostate and lung cancer AI adoption will come later.

The Takeaway

The main takeaway from RadNet’s Q2 call likely depends on your role within imaging. That said, its statements and activities certainly suggest that the major imaging center companies will get larger and more JV-centric, there’s still plenty of reasons to be optimistic about AI (and to be patient with it), and the demand for technologies that solve imaging’s efficiency problems continues to grow.

UnitedHealthcare’s Imaging Designation

Posted on by Jake Fishman

UnitedHealthcare continued its war against imaging costs, introducing its new Designated Diagnostic Provider program. This program is built to drive more exams through providers that meet UnitedHealthcare’s definition of quality and cost, and could have a big impact on its imaging partners.

Designated Criteria – Hospital outpatient and freestanding imaging centers that are contracted with UHC to provide advanced imaging (MRI, CT, PET, MRA, nuclear) must apply to receive Designated Diagnostic Provider status. Imaging providers who don’t meet UHC’s cost / quality criteria will be instructed to make specific improvements or settle for “non-Designated” status (they’ll still be in-network).

Patient Incentives – UnitedHealthcare patients referred for advanced imaging will be automatically sent to Designated Diagnostic Providers, and will face far higher co-pays if they somehow find a non-Designated imaging center (e.g., $680 vs. $290 for a CT).

Designated Dilemma – UnitedHealthcare’s contracted imaging providers will now either have to adopt what are surely UHC-friendly policies, or brace for a lot less UHC patients. These Non-Designated Providers would also have to be okay with charging UHC patients far higher co-pays than if they went to a Designated Provider.

UHC’s Outpatient Push – UnitedHealthcare has been aggressively shifting patients away from hospitals and towards outpatient imaging centers for quite a while, and this latest move ensures that most of these outpatient exams will happen at its preferred imaging centers. 

The Takeaway
One of the ways UnitedHealth Group achieved its massive growth was by steering patients to the highest-value procedures and treatments. The new Designated Diagnostic Provider program seems like a very effective way to apply that strategy to medical imaging coverage, even if many imaging providers might not like it.

Growing with Desert Radiology

Posted on by Jake Fishman

Desert Radiology executive Matt Grimes starred in a recent Aunt Minnie webinar, detailing the Las Vegas radiology group’s operational and growth strategy, and sharing some very relevant takeaways for imaging providers and vendors. 

About Desert Radiology – Desert Radiology (DR) operates 11 imaging centers, services 14 acute care hospitals across Southern Nevada, and staffs over 80 radiologists and 500 clinical/support teammates. DR was founded nearly 55 years ago, but it has nearly doubled its imaging centers and radiologist workforce in the last five years.

Challenges – Desert Radiology faces more than its share of challenges, some of which are unique to the Las Vegas area (large managed care population, no local radiology med school programs), and some that are common across the country (radiologist hiring/recruitment, competition, declining reimbursements, rising volumes).

Growth Starts from Within – In order to grow without burning out its team, DR restructured its shift schedules to better fit staff members’ needs and diversified its radiologist career paths to match their personal goals (e.g. multiple partner tracks, an associate track, and a telerad track). 

Engagement Pivot – DR previously relied on radio and billboard ads to reach new patients but pivoted towards a community engagement strategy, with a focus on outreach, charity work, and deepening its relationship with local providers and partners.

Population Health Partnerships – Because of Las Vegas’ high concentration of managed care patients, Desert Radiology places considerable focus on reducing unnecessary imaging and achieving early/accurate diagnoses. This patient environment has also driven DR to deepen its local healthcare relationships, leading to new population health-appropriate agreement structures and referrer programs.

Selecting The Right OEMs – When evaluating new scanners, DR first examines image quality by having its radiologists evaluate images while blinded to the scanner brands (avoiding bias). It then evaluates the proposed scanners’ ease of use, workflow fit, and overall value, before making a final decision.

DR’s Case for United Imaging – Grimes also detailed how Desert Radiology has benefitted from working with United Imaging (the webinar’s sponsor), specifically highlighting the value of UIH’s “Software for Life” (scanners automatically updated with future software) and “All-In” (scanners include all possible features/packages) policies.

The Takeaway – We get plenty of insights from the commercial and academic side of radiology each week, but operational insights are still rare, making this webinar particularly useful for the many imaging groups with similar goals and challenges as Desert Radiology.

Intermountain’s Imaging Centers

Posted on by Jake Fishman

Intermountain Healthcare expanded into outpatient imaging with the launch of its new imaging center subsidiary, Tellica Imaging. Plenty of hospital systems have outpatient imaging centers, but how and why Intermountain created Tellica brings some important takeaways.

About Tellica – Tellica Imaging plans to open a fleet of outpatient MRI and CT centers, starting with three Utah locations by late 2021, five locations in 2022, and more locations in “subsequent years.” The Tellica centers will prioritize patient convenience and value, targeting easy-to-access locations and adopting a novel flat-rate pricing model that’s well below typical in-hospital rates.

The Value-Based Angle – Given Intermountain’s role as one of the country’s flagship value-based care systems and its unique payor-provider structure, launching a series of imaging centers that are lower cost and more convenient makes a lot of sense. It’s also a step away from the hospital-based/owned procedure trend that’s helped hospitals from a reimbursement perspective, but brought a long list of unintended consequences (higher patient/payor costs, provider consolidation, imaging overuse, etc.).

The Payor Angle – Even though many patients use Intermountain’s in-house insurer (SelectHealth), Intermountain also works with a long list of commercial and government payors, nearly all of which have been incentivizing (or forcing) health systems to move more imaging procedures to outpatient centers. SelectHealth likely has the same preferences.

The Offsite Trend – In addition to the above payor pressures, there are some major trends underway that favor offsite imaging, including the rapid adoption of at-home/remote patient care, new COVID-related offsite policies, and the federal government’s efforts to make healthcare procedures more “shoppable.”

The Takeaway – Hospital-owned outpatient imaging centers aren’t all that unique, but Intermountain’s structure definitely is (payor-provider, value-based, non-profit) and so is its decision to launch these centers with such a patient-friendly value proposition. Even if most hospitals aren’t yet ready to offer flat-rate scans, the factors that drove Intermountain to create Tellica are likely forcing plenty of other systems to rethink their own approach to offsite imaging.

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