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Hospitals Running Medical Practices
By Jim Knaub

The idea of hospitals displacing radiology groups and hiring radiologists as employees strikes me with a foreboding sense of déjà vu. It seems we’ve traveled this hospitals-running-medical-practices path before, and it wasn’t a pleasant walk. But the anticipated benefits still seduce administrators.

By hiring their own radiologists, hospitals would maintain greater control and—if they manage the practice well—keep some of the profit that normally flows to the radiology group. Who wouldn’t want more control and profit? But managing the practice has proven easier to say than to do. Recognizing the problem with the ’90s wave of practice acquisitions, Marc Halley, CEO of the Halley Consulting group, offers these ideas to avoid making the same errors. While there are examples of hospital organizations successfully managing medical practices, it doesn’t seem the norm.

Many see healthcare reform driving care delivery toward some form of accountable care organization (ACO). This model shares some organizational characteristics with hospital-owned physician practices, but ACOs feature reimbursement incentives that differ significantly from fee-for-service care.

Where imaging fits into this anticipated (some say dreaded) new environment remains to be seen. Will the traditional radiology group remain the model or will practices morph into the so-called hybrid practice combining on-site radiologists and teleradiology support? Will radiologists work as hospital employees or partners in multispecialty groups? Will some new version of medical management companies gain sway? Around the country, some radiology groups and hospitals are already placing their bets on what they believe will prove the winning format.

— Jim Knaub is editor of Radiology Today.