With radiology continuing to refine its niche in a rapidly evolving healthcare environment, Sruti Nataraja, MPH, managing director at the Advisory Board Company, believes that one of the major themes coming out the past year is, “The consumer-driven health care market has arrived.”

As a leader of the Imaging Performance Partnership at the Advisory Board Company, she hears from many radiology leaders that imaging programs must compete in a market filled with savvy shoppers—whether they are patients, referring providers, employers or insurers—who are demanding increasingly higher service standards.

“We feel that tomorrow’s imaging market will be won by the select providers who craft a strategy to advance affordability, access and appropriate care to protect and gain market share,” Nataraja says. She believes that radiology practices will need to take steps to understand imaging patient preferences, compete in an era of price sensitivity, optimize outpatient imaging access and implement imaging clinical decision support.

Key developments in 2015

One of the biggest developments of 2015, according to Nataraja, was the fact that patients became more discerning consumers.

“Imaging directors are noticing that patients are actively asking about price and shopping around for imaging services based on service and convenience,” she says. In fact, patients are expecting better customer service from providers on a number of levels, including issues related to cost, access, quality and service.

“You’ve got to do it all to win their business,” she urges. “And catering to this sort of expectation is a tall order for most organizations.”

Two additional key developments of the past year for imaging came out of the Medicare Physician Fee Schedule, Nataraja adds. First, CMS will continue its focus on the implementation of clinical decision support, with the appropriate use criteria approval process set to begin January 1, 2016, but with a delay to the provider implementation deadline. “Additionally, CMS will cover lung cancer screening, a significant positive development for radiology,” she says.

Consolidation: The benefits

Looking ahead to 2016, Nataraja believes that radiology will continue to feel the effects of the trend towards hospital consolidation—including their own consolidation trend in response. In order for imaging leaders to benefit from consolidation, Nataraja suggests considering the following questions:

• What will your governance structure look like? How will leadership be organized for radiology services across your sites of care?
• How will you allocate radiology services? What services will you offer at each site, and why?
• How will you promote insight sharing and fair distribution of work for your radiologists across sites?
• What role will IT solutions play?
• In situations where your organization works with more than one radiology group, how will you develop a collaborative culture?
• How will you keep your technologist staff nimble and able to work across different sites? “Cross-training is not enough,” Nataraja says. “ You’ll want to have top-notch productivity metrics in hand.”
• Finally, how will you ensure a positive patient experience, regardless of which site a patient enters into your system?

While the question of provider consolidation is out of an imaging leader’s hands, she observes, he or she can prepare for it by doing an assessment based on these questions.

“I think we can play a collaborative role to improve efficiency and quality across the health system,” she states.

Consolidation: The challenges

Radiologists also will face challenges associated with consolidation in 2016. Nataraja thinks the biggest one will involve achieving the integration of IT solutions that allow radiology practices to deliver consistent care across a healthcare system.

In order to achieve this radiologists must overcome two obstacles. First, imaging providers have to find IT solutions that enable them to integrate disparate RIS and PACS systems that often operate within the same health system.

“The productivity implications of system-wide imaging are tremendous and it will be interesting to see how a solution, or a combination of solutions, helps providers reach this goal,” Nataraja notes.

Secondly, radiology must provide the aforementioned “consistent product” across the health system. Nataraja suggests the first agenda item be consistent and structured reporting throughout the system.

“Give referring physicians and patients the peace of mind that they will receive the same quality report regardless of which site of care they chose in the system,” she advises.

Practices will also need to leverage physician expertise across the system. “Throughout health care, there is a call for clinicians to work to their top of license,” she says. “For imaging, this means ensuring that physicians with subspecialty expertise are reading most, if not all, of a health system’s images in their areas of expertise. We obviously still need these radiologists to read their fair share of plain films, but being able to offer subspecialty reads throughout the system is not only good patient care, it is good business.”

Adding value in 2016

Nataraja also suggests that radiologists understand that hospitals now expect more from radiology practices than just reading and reporting exams and improving clinical service.

Practices need to go a step further and position themselves as “trusted partners who are too valuable to lose,” she recommends. This can be accomplished by doing things like helping develop new programs like lung cancer screening programs or lending their expertise to help implement clinical decision support.

“I recognize that very few radiologist contracts incorporate non-work RVUs, which dis-incentivizes radiologists from pursuing non-traditional roles outside of the reading room,” she says. “As an industry we’ve got to find a way to track and provide credit for work outside of the reading room.”

Nataraja notes that radiology is going through a transformational period and that imaging leaders will need to wield a variety of “soft” skills and competencies to help their practices develop thriving, sustainable programs. This skillset includes the ability to build and strengthen relationships, implement a service orientation and customer focus, communicate effectively, and manage change.

Hard skills like process management will always be important. Perhaps they will be more of a baseline expectation, Nataraja acknowledges. “But these softer general leadership skills will help radiology departments and groups achieve stability and success,” she concludes.