Helping medical practices stay independent amid waves of consolidation

Dhruv Chopra formed Collaborative Imaging in 2018 to support independent radiology practices. Collaborative Imaging is an alliance owned by physicians in independent private radiology practices with the common goal of providing the best patient care using the right combination of technology, innovative processes and a business model with the agility needed to adapt to a rapidly changing industry.

Chopra sat down with Modern Healthcare Custom Media to discuss top independent practices to acquire and the top tactics they can put in place to stay financially independent and successful.

What are the major challenges currently facing independent practices, such as radiology, that are leading them to be taken over by larger companies?

CC : The first and biggest challenge facing radiology groups is nighttime coverage. Previously, each band offered night service, which basically means 24/7 coverage. But now doctors generally don’t want to cover nights. So what we’ve seen is a tremendous outsourcing of nighttime coverage. And economically, it makes no sense because what they charge is more than the band is reimbursed by insurance companies.

The second is the recruitment and retention of radiologists. The market is changing and causing friction. Many doctors want to work from home; others want to work their own hours; some are less interested in partnerships. Therefore, recruitment is extremely difficult for independent radiology groups. The problem is compounded by competition with privately owned groups that can offer higher incomes.

The third challenge is in terms of reimbursement, profitability and take home pay. Reimbursement continues to decline in terms of what insurance groups pay out and bad debts continue to rise. If you look at the deductibles, they continue to increase, which means that the responsibility for the patient is higher. But among all this, the expenses of the groups are also increasing. They have to pay more to recruit and operate their business. This is a big pressure point for physician groups.

What key practices can medical practices implement to help them stay independent?

CC : There are three things they need to focus on. Number one is technology. Where there is inefficiency, there is an opportunity for technology to intervene. Identify the inefficiencies in your organization and identify the technology solutions that might exist to facilitate or eliminate that inefficiency. The second is to identify opportunities to reduce costs and improve revenue collection. The world has changed. Billing companies need to make sure every penny is collected. And if it’s not being collected, then explain why it’s not being collected and what the firm needs to do to help collect that money. If that means they put more effort into collecting at service time, they should. They should come up with creative payment plans for patients to pay their bills. Third, practices must create meaningful partnership models. The existing models that they have in groups today are failing. It’s the reality of the situation where if a doctor can get more reimbursement sooner, as opposed to that long partnership path, they’re going to gravitate towards that.

What technology solutions can practices deploy to improve efficiency and save money?

CC : Any group that reads for multiple locations and doesn’t have a universal worklist should seriously consider getting one. I am amazed at how many groups today still use disparate systems for each hospital. And what it does is let the radiologist swivel in their chair. The inefficiency it causes is incredible. In each group where we introduced our Universal Worklist, radiologist productivity increases by approximately 30%. They don’t work harder; they work smarter. And doctors are retiring faster. The only way to follow this is to become more efficient. Consolidate all your sites into a single working list.

What best practices would you recommend for independent practices to communicate successfully with referring physicians?

CC : Today, most referring physicians prefer notifications to be sent to them via secure SMS rather than over the phone, but there are criteria for this. You should know that the attending physician received the message, viewed the images and viewed the report. And then, setting expectations and meeting those expectations is so important. If you have recommended something as a radiologist, you expect that recommendation to be followed and you expect to see a study follow-up. If this has not happened, we should follow up with the treating physician. Radiologists need to be more involved.

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