Q&A: Shannon Werb on vRad, MEDNAX and building the ‘National Radiology Practice’ of the future

On Jan. 30, MEDNAX announced the acquisition of Radiology Alliance, the largest private practice radiology group in Tennessee. With this acquisition, MEDNAX officially entered the world of onsite radiology. Shannon Werb, president and COO of vRad, a MEDNAX company, spoke with imagingBiz about this announcement and what it means for MEDNAX, vRad and other private practice radiology groups throughout the country.


We should begin with a bit of background: vRad joined MEDNAX back in 2015. Can you describe how vRad fits into the portfolio of MEDNAX companies?

MEDNAX’s initial interest in vRad was as a growth and specialty expansion platform for the company. The company’s focus is to be the health solutions partner that takes great care of patients across an increasing continuum of services, now including radiology/imaging. MEDNAX’s focus has been in pediatric subspecialty care, neonatal care and anesthesia, so radiology was a brand new area for them. vRad brings some interesting and unique capabilities that go beyond radiology. Obviously, we have the niche segment of teleradiology—coverage in the middle of the night—but as part of our teleradiology offering, we also bring technology capabilities and telehealth. More specifically, we bring the proprietary platform we built and manufactured to enable the distribution of imaging studies across a broad network of distributed physicians. So when you add all of that up, there’s a lot of strategic value on top of vRad being the first investment in radiology for MEDNAX.


Now that MEDNAX is expanding more into onsite radiology, can you tell us a little about the company’s overall strategy?

MEDNAX is a national health solutions partner comprised of the nation’s leading neonatal, anesthesia, maternal-fetal and pediatric subspecialty providers. MEDNAX providers reshape the delivery of care using evidence-based tools, continuous quality initiatives and clinical research to enhance patient outcomes and provide high-quality, cost-effective care. As the company grows in scope and scale, it is committed to becoming the national leader in radiology by combining on-site radiology excellence with world-class technology, analytics and telemedicine capabilities. Continued investment and expansion into radiology will help the company continue its nimble yet strategic approach to growth. Roger J. Medel, MD, CEO of MEDNAX, said in a recent presentation that the company intends to be active in building its presence in radiology in 2017.


What does this strategy mean for patient care?

When you look at radiology from a high level, a patient will show up at a location where imaging will be recommended as part of their directed care. By and large, especially during the day, unless you’re in a very remote or rural location, that patient is going to receive an acceptable turnaround time by a subspecialized radiologist providing a quality result. As you spread throughout the country, however, patients may not have direct access to that specialized care, and that’s where providers like vRad come into play—we enable practices to plug into our fully subspecialized team of radiologists.

During the day in rural locations or at practices where there is no access to that specialized care, that volume can be shifted to vRad. Our managed workflow platform aggregates studies across multiple systems and makes sure the right study is read by the right physician at the right time. And these practices around the country often can’t staff subspecialized physicians overnight or 24 hours a day, 7 days a week; because of vRad’s scale, we can do that. So when you start to apply that capability nationally, a scalable workflow platform with a distributed network of subspecialized physicians, you can begin to see the direct correlation with MEDNAX’s vision – to take great care of the patient, every day and in every way.


What will be the relationship between MEDNAX and newly acquired practices such as Radiology Alliance? What are the benefits for these practices?

The first thing to emphasize here is that MEDNAX, not vRad is acquiring the practices. The organization is building what Dr. Medel refers to as a “national radiology practice” built from the combination of MEDNAX’s capabilities developed over 30 years in practice management and support and the unique capabilities optionally available through vRad’s technology and clinical services.

What are the benefits to the practices? First of all, these practices now have greater access to subspecialized coverage, which allows them to leverage the capacity we have available 24 hours a day, 7 days a week. These practices can then share studies with vRad and/or leverage vRad’s technology. Typical radiology practices today are procuring commercial off-the-shelf platforms and integrating them within their practices, but with vRad they will be able to access technology driving customizations that make sense for their local workflow. And they won’t have to, but it’s an enabler for the practice to thrive and grow in today’s market.

Also, we’ve invested significantly in data analytics capabilities over the last couple years. This allows vRad and MEDNAX’s practice partners to see what they look like today, plan for the future, decide what trajectory they need to be on and then ultimately make the changes necessary for success—all in a market that is shifting from fee for service to pay for value. Our clinical database and analytics platforms help partner practices make these decisions right away.


Other radiology groups may be concerned about this type of practice model. Should practices be concerned?

I think when you talk about radiology practice apprehensions in relation to vRad, they can be distilled to one main issue. While practices would love to have access to our scale of subspecialized physicians, our technology, and our analytic capabilities, there is the concern that if they leverage our capabilities—partner too closely with us—it might put their hospital contract at risk. I hear that time and time again. But that is not our business model.

MEDNAX’s acquisition strategy does not change vRad’s position or how we execute in the market. Our goal is to continue enabling our client partners and the organic growth business that we have today, and it’s also to help those practices that become a part of MEDNAX’s national radiology practice leverage vRad’s capabilities. When you think about it, vRad clients have access to many of the same benefits of the MEDNAX-acquired practice, including scope, scale and technical capabilities. And we plan to continue to enhance these relationships.


Do you have any additional thoughts you’d like to share?

We’re already hearing from other groups that are intrigued by MEDNAX’s model, and now that the acquisition of Radiology Alliance has been announced, I think you’re going to see even more activity. We’re also hearing from our existing partners and potential new clients, who are interested in learning how they can get connected to our continuum of partnership models that provide a platform for growth and stability.

Our goal, all along, is to use our technology, our analytics and our network of subspecialized radiologists to enhance and enable our partners. We want to help these partners get plugged in to what we like to call “High Performance Radiology.” They can do that either by aligning with vRad as a client or, at some point in the future, by aligning with MEDNAX and becoming a part of the family.