Proving Quality and Value
By Jim Knaub
As hospitals feel the pressure, expect them to put some on radiology groups.
Earlier this month, I interviewed Carlos Vasquez, MSM, RT(R), CRA, FAHRA, incoming AHRA president and division director of radiology for St Elizabeth Regional Health in Lafayette, Indiana. He shared his view on many imaging-related topics, including how the US Supreme Court’s upholding of the Affordable Care Act (ACA) might affect radiology and the challenges of thriving in a technology-driven field while reimbursement keeps declining. (The complete interview will appear in Radiology Today’s August issue.)
I also asked Vasquez what he sees as the key things radiology groups need to focus on to provide good service and maintain a good relationship with their hospitals. The first thing he mentioned was that radiologists can help hospitals’ quality, customer service, and patient satisfaction efforts by making themselves more available to referring doctors and patients. He said cultivating a good face-to-face relationship with referring physicians is crucial but also mentioned that the same could be said of patients. Vasquez quickly acknowledged that radiologists would be less productive if greeting patients became a regular part of their workflow. We talked about the value that might be added compared with the efficiency that would be lost—and that it doesn’t seem practical.
That said, it makes sense to me that an imaging administrator places value on radiologists maintaining good relationships with referrers and, ideally, more patients. More than once Vasquez mentioned that he believes providing quality and patient satisfaction will be an increasingly important consideration for hospitals under healthcare reform efforts, including the ACA.
It’s also true that many organizations are still trying to figure out how they’ll reliably measure quality and satisfaction. But if radiology administrators expect they’ll be tasked with developing and making these measures—and then held accountable for them—it shouldn’t be a surprise that they’ll expect the same from the groups their hospitals contract with to provide those services. That’s something for radiology groups to consider in assessing their services.
A second nugget came from a separate discussion with an acquaintance employed by one of the radiology management companies that compete directly with traditional radiology groups for hospital contracts. This person told me that about one-half of the time there appears to be genuine rift about service between the hospital and the existing radiology group, that opens the door for the management company to compete for the contract. The rest of the time it appears to simply be a matter of economics, where the hospital responds to the management company’s promise to reduce the cost of imaging services to the hospital. Measurable quality and satisfaction are two things these management companies promise to bring to the equation. Again, the desire for these measurables clearly seems to be on the collective minds of hospitals.
A final nugget that might fit in here: At the Society of Interventional Radiology annual meeting earlier this year, a radiology resident sought me out and showed me our March issue cover story about hospitals employing radiologists. “That’s exactly what’s happening at my hospital,” he said. Then he promptly told me he’s not allowed to talk about it.
As radiology reimbursement declines, hospitals clearly are seeking ways to reduce costs. Whether driven by this desire or one intended to replace a “troublesome” radiology group, broaden subspecialty radiology coverage, or squeeze some new revenue out of professional fees by employing salaried physicians, more hospitals are seeking tighter control over the delivery of imaging services by directly employing radiologists. As hospital leaders contemplate a healthcare marketplace increasingly driven by measurable quality and customer satisfaction, it only makes sense to expect them to want more control over services on which they’ll be evaluated and rewarded. Radiology groups facing this changing dynamic would do well to ask whether their group is doing all that it can to make the hospitals with which it works comfortable that all such matters are well under control. People hesitate to change something they believe is working—it’s worth a group’s time to bolster that perception.
— Jim Knaub is editor of Radiology Today. |
