Whitney Palmer

Healthcare. Politics. Family.

New Factors Driving Hospital Acquisitions

Published on the Sept. 18, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

It’s no secret that more and more independent imaging centers have become hospital-owned entities over the past few years. But now, a new set of industry forces are fueling this trend, and experts say hospitals and practices must cooperate to make these care partnerships effective.

In an April Diagnostic Imaging survey, 70 percent of radiology professionals reported they were either “very” or “a little” worried about facing a hospital acquisition. According to Brian Baker, president of Regents Health Resources, a national medical imaging and imaging business intelligence consulting firm, the industry is facing a different set of factors making radiologists nervous.

What’s Driving Hospital Acquisitions

“For the most part, imaging providers do what they’re asked to do. They don’t direct care,” Baker said. “And, as the marketplace continues to change and focus more on risk-sharing, imaging centers are becoming more vulnerable and are losing leverage.”

With the health care industry’s move toward the accountable care organization (ACO) model, finding ways to control costs while securing appropriate reimbursement levels is priority No. 1 for many clinical settings. Independent imaging centers, however, have little negotiating power. But as hospital-owned groups, they can benefit from a hospital’s or health system’s superior bargaining position with payers.

While this concentration on the bottom line is important, finances aren’t the only force pushing hospital acquisitions. Including imaging centers under a hospital’s umbrella and linking the group to the facility’s electronic health record can also help both settings comply with the federal Meaningful Use requirements for the adoption of electronic records.

“One of the challenges currently is that independent imaging locations are often not on the same medical record system as the hospital,” Baker said. “By acquiring an imaging group, a hospital can be proactive in integrating services and patient records.”

The industry’s shift toward more collaborative, integrated care — and the growing concern over reimbursement levels — has also caused a spike in scrutiny over all Medicare claims, said Michael Sanderson, president of RemitDATA, a professional medical reimbursement and claims management company. Independent imaging centers, often ill-prepared to weather long-term audits without harm, can benefit from hospital support.

“All the different audit administrations are out in full force to stop fraud and abuse, and a lot of practices aren’t equipped to deal with being put on 100 percent pre-pay audit if Medicare believes they have fraudulent billing,” he said. “Having claims pulled for adjudication can delay cash by six months to a year, and many can’t handle the risk of being pushed to come up with that much operating capital on their own.”

Acquisition Impacts

Opponents to hospital acquisitions characterize these relationships and oversight as a loss of autonomy, Sanderson said, but it also eliminates much of the stress that independent radiology groups and providers experience. Many are happy to accept capped incomes and relinquish the flexibility of designing their own marketing tactics in favor of secure employment in an uncertain economy.

Some in the industry also worry that the specter of a hospital acquisition can hamper a practice’s ability to attract new providers. If a radiologist is reticent to sign on, his or her reluctance is most likely to stem from how the acquiring hospital handles the purchase, said Arun Jethani, chief executive officer of Medical Imaging Specialists, an organization aimed at helping hospitals, imaging centers, and radiology practices maximize their profitability.

“Hospital acquisition isn’t new for doctors, so a lot of how they respond depends on what the hospital’s reputation is. Either the facility’s good at it or they’re not. Hospitals should be transparent in their expectations, but they should also pay attention to what practices want,” he said. “For the most part, radiology groups see a lot of people coming right out of a fellowship or residency. These providers are looking simply looking for a position.”

To read the remainder of the article at its original location: http://www.diagnosticimaging.com/practice-management/content/article/113619/2103337


September 19, 2012 Posted by | Healthcare | , , , , , , , , , , , , , , , , | Leave a comment

Is Refurbished Imaging Equipment Right for You?

Published on the June 21, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

If you’re looking to add another CT or MRI machine to your imaging suite or you need to replace one that will no longer pass muster under accreditation, you’re likely juggling the question of whether to buy a refurbished machine.

Acquiring refurbished versions of these machines is a growing trend as practices and facilities grapple with concerns over decreasing reimbursement or consider the possibility of future consolidations. Technology advancements over the past five years — and the desire of some larger facilities to purchase the most up-to-date machines — have made CT and MRI machines increasingly available for refurbishment. These machines are best suited for refurbishment, although some less-expensive equipment — mainly ultrasounds — account for solid portion of pre-owned equipment purchases.

“You can get really high-end, latest-technology equipment for refurbishment after five years,” said Sabine Duffy-Sandstrom, vice president of Refurbished Systems (U.S.) at Siemens Healthcare. “That’s why CTs and MRIs are the leading modalities in refurbishment. Facilities tend to keep other machines, such as angiography, for a much longer time.”

An Increase in Demand

If health care reform passes U.S. Supreme Court scrutiny this month, the industry anticipates approximately 37 million new patients will have access to clinical services. It’s possible this uptick will translate into a 14 percent jump in diagnostic imaging utilization, according to a recent study based on Kaiser Permanente data from imaging consultant firm Regents Health Resources in Tennessee.

As a result, Regents president Brian Baker predicted imaging centers could run an additional half-million scans during the next decade, meaning you must find a way to meet the increase in demand. The good news, he said, is that you don’t always have to purchase a new, $1.5 million machine.

“You have to take a look at the entire market. The most advanced technology might be a 3T MRI machine, but you don’t necessary need it to accommodate your patient base or the kinds of exams your referring physicians are ordering,” Baker said. “Often, we recommend refurbished equipment because it’s so much better and faster than what they already have and it will help them better meet the standards of care without carrying the larger price.”

The Refurbishing Process

It could be tempting to think of a refurbished machine simply as a used one with a proverbial new paint job. But that’s not accurate, Siemens’ Duffy-Sandstrom said.

“Everyone tends to use the word refurbished,” she said. “So, when facilities are looking to buy not-new equipment, it’s very important to understand the differences between refurbished and used, especially with the concerns about lowest dose and CT scanners.”

According to Duffy-Sandstrom, Siemens follows a five-step process when refurbishing equipment. First, the refurbishment team considers the machine’s age, performance, and service history. They also check whether the machine’s software and hardware can be upgraded and if service parts will be available for the next five years. Next, the team de-installs the machine and ships it back to a Siemens factory in its original packaging.

Machines are cleaned, disinfected, and painted; worn parts are replaced; hardware and software updates are installed; and the machine is reset to new customer specifications, she said. After passing a final check, refurbished machines receive a quality seal.

The same Siemens team re-installs the machine, which carries the same warranty as a new machine, with the new customer and provides standard training.

Other companies, such as Philips and GE Healthcare, also refurbish their machines. Philips’ five-step process is similar to what Siemens offers, and it focuses on bringing a wide range of modalities to customers looking to purchase updated machines on a budget, said Jim Moran, director of equipment remarketing for Philips Healthcare for North America.

On the other hand, purchasing a used machine from a third-party retailer is an option. There is no hazard to doing so, Moran said, but all updating processes are not created equal. It’s akin to purchasing a used car — you must choose from what the dealer has on the lot.

“Not everyone can access the proper software and safety upgrades for all machines,” he said. “This is a big investment so you want to make sure the refurbisher has sound processes. My guidance to clients is to go to the facility, oversee the process, and be mindful of whether the equipment looks new and has been brought up to current industry specifications.”

To read the remainder of the article at its original location: http://www.diagnosticimaging.com/practice-management/content/article/113619/2085269?pageNumber=1

June 25, 2012 Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment


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