Arl Van Moore Jr, MD, FACR, says, “I’m the 50,000-foot guy.” Van Moore chairs Strategic Radiology, LLC, a consortium of 15 major radiology groups linked to pursue cost savings, better patient care, data mining, and pure old-fashioned clout for radiologists. The trouble is that there are many 50,000-foot visionaries at Strategic Radiology.
Incorporated in Delaware, Strategic Radiology has no headquarters and has only a single employee, paid as a consultant. It currently is seeking a nonphysician administrator. The bulk of the work at Strategic Radiology is shouldered by the member physicians and administrators as volunteers.
Strategic Radiology is not, however, some agglomeration of amateur hopefuls tentatively moving forward. Its 15 members (see table) are all large, successful radiology practices. Their physicians (who number more than 892) and administrators know the professional radiology landscape. They have built their practices, over the years, from minor to major. Strategic Radiology, to them, represents a next step.
The venture is so new, however, that nobody is sure what the next step will be. The group certainly isn’t saying that someday, the Strategic Radiology brand will be stamped on imaging centers across the United States, nor does it predict that Strategic Radiology will be contracting nationally with providers and payors for radiology services. These ideas are being discussed, but implementation of a thoroughgoing national imaging service of the megagroup sort is still a glimmer on most Strategic Radiology members’ horizons.
What Strategic Radiology has concentrated on, thus far, is what Van Moore calls the low-hanging fruit of expense reduction: consortium-wide purchasing agreements for supplies and equipment, along with data sharing on malpractice insurance, billing practices, and other topics. Van Moore, who is a past chair of the ACR®, is president of Charlotte Radiology, a North Carolina practice that is one of Strategic Radiology’s 13 founding members. Two groups have joined since.
“We’re just doing the basic block-and-tackle work at this point, having taken the long view of working more closely together,” Van Moore says, adding that savings to members so far “have been more than enough to pay for the capital calls to keep the organization running.”
According to Steve Duvoisin, CEO of Inland Imaging, LLC (a Spokane, Washington, practice that is another of Strategic Radiology’s founding members), the savings seen through information sharing have, in some instances, been considerable. When Strategic Radiology’s members compared notes on malpractice insurance, he says, one group decided that the premiums for the coverage levels of $5 million per occurrence and $9 million per year were excessive. It followed the lead of most other members by cutting coverage back to $3 million per occurrence and $5 million per year. “It saved $140,000 per year,” Duvoisin says.
“As we saw the evolution of radiology, we felt it was time for radiology groups to start working more closely together. There had been wake-up calls that things were changing.”
—Steve Duvoisin, finance chair,
Strategic Radiology, Chicago, IL
Both Van Moore and Duvoisin (Strategic Radiology’s finance chair) stress that Strategic Radiology is owned and operated by radiologists; this is something that the founding groups, themselves radiologist-owned entities, demanded from the very beginning. “We saw a need and wanted it physician owned and run,” Van Moore says.
Indeed, there is no doubt that the consortium’s fundamental reason for being is to retain a radiologist’s hand on the tiller as the industry is reshaped by health reform, pay for performance, sophisticated utilization management, and the increasing shifting of private physician practices into hospital ownership.¹ “We have no plans to go public,” Duvoisin says. “We’re there to serve our members.”
How Strategic Radiology Began
Whether Strategic Radiology was born abruptly or emerged from a long developmental process depends on who’s telling the story. The versions of administrators and physicians are not contradictory, however. According to Duvoisin and others, administrators from Strategic Radiology’s founding groups had been seeing and talking to each other for years at meetings.
“As we saw the evolution of radiology, we felt it was time for radiology groups to start working more closely together,” Duvoisin says. “There had been wake-up calls that things were changing.”