Not so long ago, the sky seemed the limit for outpatient imaging centers. After modest growth through the 1990s, the number of freestanding imaging centers spiked 25% in 2001 and 15% in 2002. But growth fell to 6% in 2005, the year the Deficit Reduction Act was passed, and went down to 4% in 2007, when the DRA went into effect.

The outlook remains far from dismal, however. The demand for outpatient imaging will explode in the next decade. When the last of the baby boomers reach age 65 in 2020, total annual imaging procedures are expected to rise 140%. And competition in the outpatient imaging sector will be reduced, as the downstream effects of the DRA have already winnowed an estimated 10% of the smaller imaging centers.

Outpatient imaging centers nevertheless need to concentrate on profitability tactics to grow their business. One key strategy is to plan for increasing revenue by introducing new clinical service lines. Savvy imaging centers are identifying growth potential and long-term revenue opportunities by paying attention to national trends in imaging, meeting the needs of physicians in their local communities, improving relationships with their referral base, putting imaging data to clinical use, and enhancing patient satisfaction.
 

HEEDING NATIONAL TRENDS

Carmichael Imaging of Montgomery, AL, added state-of-the-art women's health and oncology services to its base of routine diagnostic imaging in 2002. For oncology patients, the center offers general radiography, ultrasound, MRI, nuclear medicine, and PET/CT. Carmichael has distinguished itself by becoming the only center in the Montgomery metropolitan area—population more than 366,000—to provide fixed PET/ CT. It currently performs 16 to 20 PET/CT scans per day, which is more than double the number done in an average imaging center, according to industry estimates.

For women, Carmichael provides a full range of breast diagnostic services, including digital mammography, breast ultrasound, breast MRI, stereotactic core needle biopsy, and MRI-guided core needle biopsy. It is the only center in Montgomery to provide breast-specific gamma imaging.

"We added breast-specific gamma imaging as a functional aid in the diagnosis of breast abnormalities," said administrator Tommy Patterson.

Figure

By focusing on oncology and women's health, Carmichael has positioned itself for the future in keeping with imaging growth predictions. Of the top 10 national clinical service lines poised for the most pronounced expansion nationwide in the next two years, oncology ranks third, according to Thomson Healthcare Data Trends. Between 2005 and 2010, oncology services are projected to rise by 67%, leading to double- and triple-digit increases in cancer-related imaging procedures. PET procedures are expected to shoot up by 202% and CT by 89%.

Breast MRI in the U.S., meanwhile, increased 23% in the first half of 2008 over the same period in 2007, according to data from the Imaging Market Guide. The Millennium Research Group's U.S. Markets for Women's Health Imaging Systems reports that MRI and breast-specific gamma imaging will increase at a compound growth rate of 28% over the next five years.
 

ADAPTING TO THE LOCAL MARKET

Crystal Run Healthcare, a multispecialty group practice in Middletown, NY, is one of the fastest growing medical practices in the country. It has increased from two physicians in the mid-1990s to 150 today, and it will have 200 primary and specialty physicians a year from now. The group practice started on its growth path when founder Dr. Hal Teitelbaum realized that a two-person single-specialty hematology/oncology practice could not meet patients' needs.

Table 1

"I could not assure my patients the availability of quality physicians. If I needed physicians to help take care of a patient, whether as an outpatient or inpatient, they might not be available either in the right location or at a particular time of day. Even if they were available, not all physicians are created equal," he said.

Teitelbaum came up with what he calls the doctrine of unavoidability. This holds that a medical practice needs to differentiate itself on the basis of quality and service excellence as well as size and scope in order to be deemed essential by payers, patients, and other providers. Crystal Run now covers primary care from pediatrics through geriatrics, ob/gyn, neurology, dermatology, general surgery, urology, orthopedics, and plastic surgery. It provides not 100% of all clinical specialties, perhaps, but probably 95%, Teitelbaum said.

Imaging has kept pace with the expansion of the medical practice. Crystal Run got involved in imaging in a small way in 1999. It set up a single general radiography room and hired technologists to do plain films but sent the scans to a tertiary-care center in New York City for reading. In 2002, the medical practice started providing full-service diagnostic ultrasound, digital mammography, CT and MRI, echocardiography, nuclear medicine, and bone mineral density testing at one site. It included the same mix of imaging modalities when it opened a second site in 2004. The medical practice is in the process of building another 127,000-square-foot office that will also include the region's first 3T MRI. All along, imaging acquisitions have responded to specialists' concerns about access.

Pages: 1  2