"It makes sense, because hospitals provide the kind of leverage in negotiating contracts with managed care organizations that imaging centers do not have," says Locke.

The discussion will also focus on referral patterns and physician alignment, tighter oversight from regulatory agencies, and reimbursement and "the payer mix," but the evolution toward partnership is a critical topic and one motivated by economic uncertainty and today's tumultuous marketplace, which could require the kind of cash infusion that hospitals may be able to provide.


"Independent imaging centers have become less profitable than they used to be, so a hospital partnership may provide an independent operator with an opportunity," Locke says.

Another important issue at this year's Imaging 100 conference is vertical integration and diversification. CEOs, CFOs and COOs will be discussing market strategies for business development, and extending their franchise into different product offerings.

"It's about the relationship that you have built with your market-base and evolving that single modality offering into a more vertically integrated imaging center," Locke says. "It gives you more of a continuum and follows the diagnostic and therapeutic chain of events."

Opportunities for integration include the development of outpatient interventional radiology, vein clinics and pain management clinics. Many imaging centers today are especially involved in the management of back pain.

The integration of radiology oncology departments is also being explored. A small minority of imaging centers have integrated oncology units. Locke estimates it to be under 10 percent, but it is an emerging trend.

"There is a logical connection between diagnostic imaging and the therapies related to radiology oncology," says Locke. "Most, if not all of the patient work-ups require significant medical imaging to stage the disease and track tumor movement and in some cases guide their intervention. There's a natural synergy."

Other important topics to be discussed include operation automation.

"The primary solution would be to explore a more robust, integrated RIS/PACS platform," says Locke. "RIS and billing systems and other forms of data that exist when packaged with a signature PACS profile can really offer an imaging center a much more available database with which to mine the data for various dashboards and metrics."

Imaging businesses can also perform market analyses of patient demographics and design the imaging center around the specific disease states and related diagnostic and therapeutic imaging needs of a particular patient population, says Locke.

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