How to Improve Volume in Your Practice

May 12, 2011

Better scheduling, reminder calls, and skillful staff will let you get more patients through each day.

Decreasing reimbursement from payers, decreased utilization, and multiple procedure discounts are driving many facilities out of the market, or at the very least, making it extremely difficult to operate in the black. 

In this tough environment, one answer continually resurfaces:  VOLUME, more volume.  How do you mitigate the decreased reimbursement?  More volume.  How do you offset the multi-procedure discounts?  More volume.  It seems that this answer is the solution (or one of the best) to most of the difficulties in our current environment.  The comforting thing is that growing volumes in your facility may be easier than you think. 

Let’s look at MRI for examples of opportunities.  How many no show patients to you encounter?  How many patients show up late, or get rescheduled?  How many are cancelled because of pacemakers etc.?  How many days out are you scheduled?  What is your competition doing?
Answering these questions honestly will give you an indication as to your opportunity here.  Do you confirm your patients the day before their MRI?  A simple call by the technologist will work as a reminder, an opportunity to briefly screen patients, and a chance to instruct the patient as to how to dress for the exam in order to decrease delays at your facility.  Decreasing no shows in the MRI and CT area should be a primary focus of your daily operations.

Do you have a high number of patients that refuse their exam, or reschedule after attempting their exam?  If this is an issue, your problem may lie in your staff.  Improperly trained staff, or staff members with a less than positive attitude can directly affect the patients in your MRI environment.   Anxiety can quickly escalate in to a sense of claustrophobia if it is not identified.  Taking a couple of extra minutes to calm these patients down, talk with them between sequences, or even have someone to hold their hand during an exam can be the difference between a billable exam and a lost charge. 

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You can often avoid cancelling exams because of pacemakers, or rescheduling because of the need to research implants.  The reminder call should identify the pacemakers.  We also incorporate a pacemaker question into the order forms we supply to our physician offices (though it is not 100 percent reliable).  As for the implants, there are many different resources available to research the different implants and foreign bodies that many patients have.  Having at least one MRI technologist knowledgeable in this arena will minimize loss due to this concern.  Unfortunately, sometimes you are at the mercy of another facilities medical records department, waiting on a surgical report.

How far out are you scheduled, and what is your competition doing?  Offering evening appointments can be an added area for your volume generation.  Especially if you have patients scheduled out for several days.  If your competition is not offering this service, it may also garner you more business, since evening appointments appeal to many of the working class patients.  Face it, your equipment is paid for at some point in the regular work day.  Adding patients to the afternoon and evening are just going straight to the bottom line.

Lastly, are you scheduling your MRI slots appropriately?  Opportunity can lie in the regular work day.  In some cases, by simply adjusting your scheduling, you can increase your revenue in MRI by 20 percent.  This avenue requires some of the newer equipment, but not necessarily a 3T scanner.  It also requires continuity in the workflow in your facility.  Done correctly, it results in more volumes, happier patients, and greater revenue.

This method can be applied to most of the modalities in the imaging environment.  The opportunity lies in applying the knowledge gained through the unbiased analysis of your daily operations. 

David Rushing, RT(R), MR, is operations manager for Medical Imaging Specialists. He has 19 years of experience specializing in radiology program development, implementation, and management. He has organized several mobile MRI programs for hospitals, served as hospital radiology department manager, and managed a full service free standing imaging center.