Ideas for Hospitals, Centers and Practices

Solution for an Ever-Expanding Problem
Recessionary Times … Time to Retrofit?
Billing Service Boosts Reimbursement

Solution for an Ever-Expanding Problem

Less than 5 years ago, the Centers for Disease Control and Prevention estimated that 60 million people living in the United States can be classified as obese, with 9 million severely obese. Hospitals and imaging providers have realized that the increasing percentage of obese patients brings about numerous challenges in the imaging suite, including concerns over the amount of radiation required to produce a sufficient image.

A medical imaging components manufacturer, Dunlee, a division of Philips Healthcare, Aurora, Ill, hopes its new product will address this pressing issue. The company’s new line of fiber-interspaced Hi-5(5 mm)Grids for CR and DR was designed to reduce radiation exposure and improve image quality in obese, as well as normal, patient examinations.

Tom Spees, Dunlee’s director of US Sales, explains that fiber interspacing material construction has a better signal-to-noise ratio than its traditionally used aluminum counterparts. Less x-ray absorption signifies a better transmission, allowing clinicians to perform imaging at lower dosing. Furthermore, the Hi-5 grid, meaning a height of 5 mm instead of the typical 3, is advantageous for obese patients or those with thicker anatomy, Spees continued. The bigger the height, the more scattered photons one can absorb. It also reduces radiation scatter caused by excessive body tissue.

“The problem with imaging obese patients is the fact that you need to have more penetrating power with the photons,” Spees said. “You need to increase the amount of energy in both kV as well as mAs in order to get enough x-ray through thicker anatomy. Because you need more photons, you naturally get more scatter off the bone. So having a higher ratio grid, the 5 mm instead of the 3 mm, gives you better cleanup during those areas where you have thicker anatomy. Studies that have been done indicate that, depending on the thickness of the patients, the dose savings can up to 60%, which is significant.”

Clinical studies performed at the Mayo Clinic reported rate reductions from 20% to 40% using Hi-5 grids. “Although Hi-5 grids are priced slightly higher than aluminum grids, optimum images and lower dose prove them to be well worth the investment,” said Pieter Nuijts, global manager of Smit Röntgen.

Spees sees two main markets for the product, one being OEMs. Manufacturers that are building new digital radiographic machines can incorporate the grid into equipment for the benefit of patient dose. Furthermore, Spees said there is a big advantage for service organizations and hospitals to update their installed base by changing their current grid with the Hi-5.

Unfortunately, Spees admits, the product’s customer base is nonexistent, something he attributes partly to the cost involved. Fiber is about 25% to 35% more expensive than aluminum. “But the quality is so much better, and the patient benefit is so much greater,” added Spees, who pointed out that leading cardiology and mammography manufacturers all use carbon fiber grids. “I’ve been really hoping to be able to get people to understand the value of an advanced grid, especially for DR and CR applications, where the imaging is more critical. I don’t think the word is out. Thus far, we just haven’t been successful in educating the marketplace that they can have all the way up to a 60% dose savings on real thick anatomy. There hasn’t been traction on it.”

Nevertheless, Dunlee hopes to make the Hi-5 grid its product of the future, concentrating its effort to spread the word about its dose reduction benefits. “If we can create some demand, we can develop the product. The product’s already been developed—it’s just a question of producing,” Spees noted, saying that the company can start rolling it out as soon as the next 2 months. “We don’t have anything planned beyond this at the moment, but this is all depending on what we can do from a research and development standpoint to test out new interspaced materials. We’re always looking for ways for people to benefit from better radiation cleanup at the lowest dose possible.”

Dunlee will be showcasing its Hi-5 Grid at the upcoming American Healthcare Radiology Administrators meeting on August 9-12 in Las Vegas.

—Elaine Sanchez

Recessionary Times … Time to Retrofit?

With the heady mix of budget constraints and a recessionary environment, hospital radiology labs and imaging centers are getting creative. They’re seeking ways to stay competitive, improve patient care, and make their capital investments last, while still conserving cash. One solution? Retrofitting.

According to InfiMed, a developer of digital medical acquisition, image processing, and sensor solutions, the retrofit option is experiencing a boost in popularity and sales. Since the fourth quarter of 2008, InfiMed has experienced an increase of 25% over 2007 and 2008 sales levels of new systems for the retrofit market through its dealer channel.

“Today’s depressed economy has choked major capital spending, yet the call for quality imaging is multiplying,” said Amy Ryan, president of InfiMed. “Retrofitting a room is a cost-effective alternative to purchasing all new equipment.”

“Our customers are increasingly receptive to our story, which is all is not lost if you can’t spend the money for an entirely new suite,” said Steve Walsh, president of Eastern Diagnostics, a dealer partner with Infimed. “Alternatives exist through the retrofit market, in which new acquisition, processing, and review technologies can be added on to existing rooms or machines. Radiology managers, CEOs, directors, and other hospital contacts are listening. As a result, as of June of this year, we’re already at 90% of our budget for bookings.”

InfiMed and its dealers on the ground attribute the increase in the attractiveness of retrofit to squeezed budgets and financial pressures, which have decreased the hospitals’ ability to make significant capital purchases in imaging suites. Hospitals can purchase equipment on a smaller scale that can be retrofitted instead of replacing entire suites at one time, improving their capabilities but retaining cash.

“Hospitals are realizing that they can solve their imaging issues by replacing entire suites for $350,000 in capital funds, or they can upgrade their digital imaging acquisition systems with their service or operating budget for less, with the same or better diagnostic results,” said Walsh. “A new room gets you a new table, but that’s just furniture. It doesn’t get radiologists more diagnostic capability. Hospitals are realizing that significant value can be had for much less with digital add-ons.”

The typical health care woes of reduced reimbursements and tight funds are doubly difficult today as they combine with a recession. It’s causing many hospitals to wait too long to replace critical equipment that threatens their ability to perform. The retrofit option, then, seems like a useful and valuable option for hospitals to prevent disaster and even improve their capabilities.

“We understand that tight budgets mean purchases of imaging equipment have to be smarter,” said Ryan. “Ours is an intelligent choice. With our platform, hospitals can image today with a CCD camera and next year, as needs and finances change, with a flat panel detector. The iSeries is flexible, adaptable, and upgradeable—requirements for survival in today’s competitive imaging equipment market.”

Walsh advises that hospitals intrigued by retrofit options think critically about how it fits into their budget, how it works with their long-range technology plan, and how long it can conceivably extend current technology life.

“Retrofit products make sense if you have a good foundation,” said Walsh. “If your room is running, but the diagnostic quality is not where it needs to be, or it’s not going to last as long as your long-term plan needs it to, retrofit options can extend the life of your room for 3-5 years. That frees up money for newer, evolving, and emerging technology to enable hospitals to be competitive. At the same time, it gives you a good solution for good value.”

—Amy Lillard

Billing Service Boosts Reimbursement

Using propriety and best-of-breed software allows CBIZ Medical Management Professionals’ Velocity billing system to get the maximum reimbursement for radiology practices. The Atlanta-based company has used Velocity to integrate the eight core billing steps that—taken together—are the key to increasing or losing revenue. According to Mark Talley, COO, about 3% to 5% of all procedures are not billed by radiology practices. Implementing Velocity is a way to not only recapture this lost revenue, but increase it as well. On average, MMP’s clients increase their revenues between 5% and 10%. In rare cases, it has even been as high as 25%. In addition, the system is designed to speed up the accounts receivable process and limit any compliance issues.

Founded in 1993, MMP offers comprehensive billing and practice-management services to hospital-based physicians across the country. Velocity is among its newest services, offered since the first quarter of 2009. Among the features of the Velocity billing service is electronic charge capture reconciliation, real-time Web-based claims management, sophisticated denial management tools, managed care reimbursement tracking, eligibility verification, online payment portal, and advanced coding process and ongoing coding education.

The automated billing system is tailored to the needs of each client. All individual contract information—including those for both private and government payors—is loaded into the system. Talley said that the key to what MMP offers isn’t the billing per se, but what he refers to as the backend, particularly in appealing denials, a task that is typically ignored in busy, cash-strapped practices. The company charges a certain percentage of the reimbursements that it captures.

When implementing Velocity, MMP meets with the radiology group and works to offer the service in a way that will fulfill its needs best. For instance, Radiology Consultants Unlimited (RCL), Reno, Nev, transitioned from an in-house billing department to MMP. RCL had numerous needs, particularly in terms of its tax obligations, which MMP was able to address and use Velocity to plan ahead to meet these obligations. MMP is also offering the practice ongoing financial projections related to its various imaging services, a value-added service offered at no cost. The MMP office in Kansas City, Kan, handles the billing operations, and liaison in Reno deals with any other practice issues that may come up and require a personal touch.

In nearby Tulsa, Okla, Diagnostic Imaging Associates (DIA), a radiology practice that has sites all over the state, retained MMP in order to be able to focus on the day-to-day needs of the practice, including aggressively expanding its teleradiology service. MMP handles all of DIA’s needs including billing, credentialing, internal audits, and tax planning. Over the past several years, net collections have doubled. MMP is also offering DIA human resources services to better manage its far-flung network of physicians and hospitals.

The individualized service combined with the most advanced electronic billing system makes MMP and its Velocity service an attractive option for radiology practices that don’t want to handle billing in-house.

—C.A. Wolski