Becker's Hospital Review | August 28, 2013

By Teri Yates

While hospital employment of radiologists is less common than in other specialties, there is increasing reliance on this strategy to better align radiologists with health system priorities.

Under an employed model, hospital leaders clearly have the leverage they seek to improve care coordination, drive performance improvement or eliminate competitive activities such as imaging center ownership by their radiology group. These potential benefits come at a significant cost though, with financial losses likely in the early years due productivity declines and expenses related to the acquisition and technical integration of the practice. Given the potential negative economic impact of physician employment, it can be advantageous for hospital leaders to focus instead on improving the terms of the existing professional services agreement.  

Determine what success will look like
When using the PSA as an instrument for change management, it is important to clearly establish the objectives of the negotiation. These should broadly include promotion of clinical practice that conforms to evidence, along with proactive performance measurement and improvement. Establishing a shared focus on competitive concerns should also be an important outcome. The first task in achieving these goals is to distill the needs into specific metrics that can be easily measured and reported. Once identified, the metrics can then be included in the agreement as a guide for minimum performance thresholds, to structure pay-for-performance incentives, or as a combination of both.