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September 15 , 2006 • Volume 1 • Number 10

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Imaging’s “Hail Mary” Moment

By Curtis Kauffman-Pickelle

You know the scene. The big football game is down to the final two minutes and the score in the cross-town rivalry is agonizingly close. The only way for our favored team to win is to launch a last-minute pass down field in the vain hope that amidst the chaos the ball will somehow find its way into the hands of our receiver and he will get into the end zone. It’s known as a Hail Mary pass precisely because its chances of success are extremely slim and one hopes for divine intervention to ensure miraculous success.

So here we are. The mid-term elections are nearly upon us. Democrats and Republicans are slugging it out to a close finish on a host of very complex and profound political-football issues, any one of which could keep lawmakers from paying even scant attention to the Access to Medical Imaging Coalition initiative and related DRA rollback legislation.

No, the game is not over yet: there is work still to be done, lobbying calls to be made, charts and graphs yet to be drawn, a lot of turf still to be pounded. The fight remains intense and all of us are in it to the finish. Yet in the huddles taking place in boardrooms at outpatient imaging practices around the country the discussion is turning increasingly to how one emerges in January as a survivor within an entirely new model of competitiveness. One senses a certain resignation now driving 07’ budget preparations.

Curtis Kauffman-Pickelle

I have written in the last few columns about the need for getting back to the basic blocking and tackling of our businesses in ways that will help shield us from the impact of the DRA. One must plan for the reality of the moment and that is the expected implementation of the reimbursement cuts. But the questions that I routinely am asked have to do with just exactly what should be done to plan for success.

Therein lies the rub.

If you are only just now discovering that there has been developing for some time a new world order in the business of diagnostic imaging you are at a serious disadvantage from a competitive point of view. Within this new order is much more than the DRA and its likely offspring, the mini-DRAs in our future. Included in this tectonic shift that is rocking things around in our business are issues such as emerging consumerism, the out- of-whack dependency ratios within employers’ health plans, mandated price transparency, outcomes-based provider scoring, pay-for-performance models of reimbursement, and more. Picture the Hail Mary pass being thrown when the ball is wet, maybe it’s even snowing outside, the field is slippery, muddy and downright inhospitable.

Back to the question of what to do. First, say good-bye to the past and to the way things used to be. This new world order in imaging is just beginning to show itself and those who intend to succeed will embrace the change and find ways to work within the new model. The good news is that the projected scan volumes for the next twenty years will continue to create opportunity for those savvy enough to build their new business proposition around value, relationships, quality, fundamentals, and, perhaps most important, realistic expectations. Gone are the days when even mediocre providers could enjoy amazing financial success in outpatient imaging.

After nearly 25 years studying the business side of diagnostic imaging, I find the current and future opportunities incredibly exciting. We have matured into one of the most interesting and rewarding professions in the country and our foundation has provided us with strength and resilience. I am looking forward to helping guide the way through the labyrinth as we enter this new phase.

At the same time, we will always be grateful for a little divine intervention on our behalf.

Curtis Kauffman-Pickelle is a strategic business consultant to more than 30 imaging centers and radiology practices, the managing director of Practice Builders organization, and CEO of the Imaging Center Institute.