The Rise of Vertically Integrated Women’s Imaging

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Providing the full continuum of breast care earns the loyalty of the all-important female health care consumer, considerable downstream imaging, and the mammography annuity

More and more practices are casting an eye toward vertically integrated women’s imaging as a new way to attract family health care administrators—namely, wives and mothers—by offering an unparalleled standard of care. It’s not easy, though. It requires a multidisciplinary approach where there once was competition and sizeable investments in the requisite technology. What’s the thinking behind this strategy? How is it being executed in practices around the nation? What are the potential pitfalls, if any?

Advocates of integrated women’s imaging cite the need for a coordinated approach to breast cancer as the key motivator, and note that this approach is more easily achieved in a hospital setting. After abandoning mammography in great numbers earlier in the decade, outpatient imaging providers are also discovering this strategy.

Howard Berger, president and CEO of RadNet Inc, Los Angeles, says, “Right now, the market is underserved. Until we put the surgeon, the oncologist, and the imaging specialists together within one organization, any patient identified with possible breast cancer has to see multiple physicians, and it can take months until a conclusion is determined.”

Berger is so convinced that vertical integration is the correct approach that he’s betting on it with a new RadNet division called BreastLink. In business since April 1, 2008, BreastLink offers its patients access to women’s imaging specialists, oncologists, and surgeons within a single organization.

“We want to go out to the public and let them know that we have the resources to do both the mammography and any further treatment that’s needed,” Berger says. “Then we get the benefit of doing all their imaging in an integrated fashion. Rather than lose the patient to some other oncologist, medical group, or surgeon, we keep all that imaging inside. Our surgeon can refer patients to our oncologist, our oncologist can refer patients to our surgeon, and then both groups refer all of their imaging to us.”

Gary Wood, MD, of Radiology Associates of Albuquerque, NM, says that his practice has the only fully integrated women’s imaging site in the state—and gains close to 20% of its total earnings because of it. “We’re serving a special need in the community,” he says. “Fifty percent of the population is female. There’s a huge demand for women’s imaging and a huge demand for rapid turnaround. This is a high-visibility area for our practice.”

David Gruen, MD, director of the women’s center at Norwalk Radiology, Norwalk, Conn, says that his practice puts its money where its mouth is by offering women a standard of care previously only available to providers’ friends and loved ones who knew enough to ask for it.

“The standard of care, nationally, involves a woman seeing a gynecologist, the gynecologist calling the breast surgeon, the breast surgeon calling the radiologist, and, in the end, you’re talking about weeks between detection and finding out, the vast majority of the time, that it’s benign,” he says. “The VIP standard of care is not two weeks, but two to three days. Why shouldn’t that be the standard of care for everyone, if it’s the best?”

Mark Jensen, COO of Charlotte Radiology, Charlotte, NC, has set a similar benchmark for his women’s imaging services. “We don’t call a patient back until we have an appointment time immediately available,” he says. “When a woman needs additional studies done, she’s channeled to our schedulers, who make a phone call to the patient and offer her a couple of choices for appointment times. That’s been a big customer-service satisfier.”

Investing in an Annuity

Gruen is an enthusiastic endorser of supporting the entire continuum of women’s care within one practice, based on a single simple principle. “Women’s imaging is an annuity,” he says. “If a patient messes up his kneecap skiing, we get one shot at him. We may get his MRI, but then he gets his knee fixed and we never see him again. If we do a good job on your mammogram, on the other hand, where are you coming next year, and the year after that? Then, when your husband needs an MRI, or your kids need a CT, our practice is the one getting the referrals. You can’t measure the power of that.”

There are other compelling reasons to make women’s imaging a cornerstone of your business, according