The healthcare industry is undergoing a wave of changes sparked by the shift from fee-for-service to value-based care. More patients are receiving medical services in the outpatient setting. Amid these transitions, hospital leaders need to devise new ways to cut costs and save providers headaches.
This article is sponsored by Siemens Healthineers
Now more than ever, it is apparent that consolidation within individual organizations is the key to staying competitive and maintaining costs in an era marked with hospital mega-mergers. Where can hospitals start and how can they grow those consolidated services to reap the most benefit? And, where do healthcare organizations currently stand in their consolidation journeys?
Nearly 13 healthcare leaders gathered April 13 for a roundtable discussion sponsored by Siemens Healthineers at Becker's Hospital Review's 9th Annual Meeting. Brian Drozdowicz, vice president of digital health services, and Jordan Halter, vice president of service line solutions for Siemens Healthineers, led the discussion. Topics covered included consolidation techniques and challenges to cost reduction.
Siemens Healthineers is a healthcare company that has been recognized as an innovation leader in the industry for more than 120 years and is dedicated to improving healthcare and empowering healthcare providers to transform toward value-based care, ultimately leading toward personalized medicine. Digital health services offer the whole spectrum of digital health with digital ecosystem & platforms, imaging IT, teleradiology, and population health management.
"As consolidation continues to happen [in healthcare], and there continues to be a push towards value-based contracting and population health initiatives, our customers are asking us for more," Mr. Halter said. "We see the digital unit which we represent as the key differentiator to help advance the way we do business with our customers."
Why commercialize imaging?
As the healthcare industry faces a number of mega-mergers and acquisitions, Siemens' leadership believes these newly expanded integrated delivery networks will want to rely on a small number of technology vendors and their EMR for financial success. In other words, hospitals must rethink a number of their offerings and partnerships.
Of all departments, radiology is unique in that 95 percent of all exams — such as X-rays, MRIs — can be read anywhere. The mobile nature of imaging makes it the best place to start when looking to consolidate services. "From a service-line standpoint, in a rapid consolidative market where you are trying to get local density, imaging is a really interesting service line to start with because of its ability to be so mobile and be able to move things laterally," Mr. Halter said.
"You have the ability to connect 15 different hospitals and run as one virtual department for imaging, but how do you take this to expand and grow the service line?" Mr. Halter said.
Different journeys to commercialized imaging
Imaging isn't always top-of-mind for recently merged systems trying to wrap their heads around the many other aspects of their newly-formed organization. Before initiating a commercialized imaging service, organizations must first gain physician buy-in and establish key leadership positions.
On the journey to commercialized imaging, a number of organizations begin by appointing a vice president of ancillary services who is charged with various imaging responsibilities among other duties. Then, they start looking for opportunities to expand their imaging services. This could include exploring ways of using clinical decision support to eliminate waste or picking up virtual contracts from other areas.
During the discussion, the vice president of operations for a regional health network with a medical staff of about 1,000 located in the Southern U.S. explained his organization is testing out commercialized imaging lines in its smaller markets.
A three hospital system is moving its outpatient imaging into a joint venture with another system as a result of a merger. In doing so, the three hospital system is hoping to keep costs down to align financially with its new partner, said the vice president of business operations at a health network on the East Coast.
No matter the market, many IDNs prefer not to employ the radiologists. Ensuring the various radiology groups deliver the same standards of care and minimize clinical variation is a challenge.
According to the chief transformation officer and senior vice president of operations at a nonprofit public-benefit corporation spanning three states, strong leadership is the key. Consolidation happens quickly in a merger, and hospital leaders agree it's hard to keep up, meaning they need a physician leader at the table to help make the calls. Getting physicians to think systemized, though, is especially tough because it's not what they want to do.
When it comes to imaging, the vice president of operations at the aforementioned Southern health network suggested employing an interventionist and outsourcing everything else. The leaders emphasized the importance of finding radiologists that suit a particular organization's needs.
"It's so important to have that right person," he said.
Looking for the imaging easy-button
Another challenge in bringing together multiple radiology groups is finding ways to marry their outdated and disparate systems. Roughly 30 percent of imaging orders are placed "off EMR" via fax or phone call, forcing health systems to find ways of making outsiders feel like insiders, Siemens said during the session.
The president and CEO of a regional health system in the Midwest with more than 500 facilities said his organization's solution involves a software add-on to its fax system designed to override a number of rules pertaining to ordering imaging services. That way, both the ordering physicians and the radiologists can find and deliver orders and readings much faster.
What they aren't doing
While the push to commercialize imaging lines is on the radar of many leaders, organizations aren't marketing these services, as evident from session attendees. Moreover, organizations are not lumping radiology services under telemedicine programs. Instead, most are keeping imaging lines separate from other entities.
It's clear that as mergers and acquisitions press on, consolidation is here to stay. When it comes to imaging there are a lot of other areas that need to be addressed first to achieve a concrete growth strategy. Some of these entail maximizing relationships with the payers in organizations' individual states. For example, the vice president of operations for the aforementioned large health system operating 500 facilities brought someone onto his team who had experience working with a payer. That person is looking into ways to leverage EMR data to measure value and performance. This data will be used to rethink hospital strategy — such as creating a freestanding emergency department.
Across the U.S., mergers and acquisitions are driving organizations to consolidate and commercialize their services. This is happening at a faster rate than hospitals can handle. Molding an alignment strategy tailored to spur growth to their respective regions is a top priority. Imaging is increasingly becoming a crucial component of these strategies.
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Editor's Note: The statements made by participants, described herein, are based upon their individual experiences. Since there is no 'typical' hospital and many variables exist, there can be no guarantee that other facilities will have the same experiences.