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Challenges Facing Radiology Directors
By Jim Knaub

The inbox filled up pretty quickly when we asked imaging directors to tell us what challenges they’re facing this year. While the usual suspects—reimbursement cuts and competition—were the most common challenges cited, imaging directors told us they’re seeing a range of issues in 2010. Radiology Today readers tell us that reduced reimbursement coupled with increased competition and some softening demand because of the economy are making their jobs more difficult.

It’s easy to see how these three factors can make things tough in radiology. Imaging’s growing clinical value to physicians has been a driver of procedure growth for many years. As reimbursement leveled off or dipped in recent years, that volume growth helped maintain profit margins in imaging.

But that pattern hasn’t held up this year. Readers are reporting that reimbursement is down, along with volume in some situations. Imaging organizations face an unsolvable problem when they try to combat reimbursement cuts without their traditional tool of increasing volume. Reducing costs is the only other option, and you can only wring so much savings out of a reasonably well-run facility. As one director put it, “We have done all we can do with wages and expenses. [Our] radiologist owners are just making less money.”

Not surprisingly, several imaging directors told us that they’re increasing their marketing efforts in an attempt to increase volume. Those readers also noted that it’s too early to tell whether they’re achieving any significant results. One director told us that his hospital was creating more slots for outpatient imaging exams by scheduling more inpatient exams between midnight and 8 am.

Imaging directors also told us that more insurers are requiring prior authorization for imaging studies, creating a larger administrative burden on the front end of the imaging revenue cycle. An imaging director in western North Carolina said preauthorization has become such an issue that his department created a team to handle preauthorization requirements before patients come in for exams. He added that the precertification program has helped reduce the denial rate in the system’s hospital and outpatient imaging centers. Another imaging director reported some success in reaching out to referring physicians to explain the details and preauthorization requirements of the key insurers the referrers’ practices work with regularly.

We’ll report more on the challenges facing imaging directors this year in our August issue.

— Jim Knaub is editor of Radiology Today.