August/September 2013

As Ezequiel Silva III, MD, makes perfectly clear in his guest editorial in this issue, the entire continuum of radiology delivery services is inches away from getting slammed—again. The root of radiology’s latest problem is in a 2007 report¹ (based on data of an even earlier vintage) from RTI International, LLC, that recommends separate cost centers for MRI and CT.

Persistent decreases in outpatient imaging reimbursement and a dramatic decline in volume finally took their toll on the imaging-center market, with a resulting 3.65% decline in the total number of freestanding outpatient imaging centers. This is the first contraction since the dip that followed the stock-market crash in 2009.

Alignment increasingly occupies the thoughts of health-care stakeholders—insurers, legislators, and regulators, but especially hospitals and physician groups. Because alignment sets the stage for service and quality improvements, as well as for the implementation of cost-control mechanisms, the interest is warranted. Hospitals have sought to employ both primary-care and specialty physician practices for the ability to impose quality and cost uniformity through top-down policies, procedures, and cultural mandates.

When hospital executives express dissatisfaction with professional radiology services, local radiology practices should put on their nimble-response shoes and communicate. If they don’t, national teleradiology companies will, and the experience at Stamford Hospital in Connecticut is a case in point.

With more than 800 active health IT applications to maintain, Bill Russell has no time for distractions. The senior vice president and CIO of St Joseph Health—a nonprofit integrated health-care network that includes 14 hospitals in California and Texas—has a lot on his plate. There’s even more since the system’s February 2013 affiliation with the network of Hoag Memorial Hospital Presbyterian to form the regional Covenant Health Network (Irvine, California), covering an area stretching from California’s Orange County to the High Desert.

CMS proposes paying hospitals the same amount for a head CT exam as for a skull radiograph in 2014.