Managing the Volume to Value Transition: Central Illinois Radiology Associates

Central Illinois Radiology Associates (CIRA), a private practice with 70 radiologists—including 48 subspecialists—has been successful in continually growing its market share since its formation in 2000. “We were formed when two radiology groups came together, and since then we’ve added 40 physicians,” says Eric Weber, CFO of the group. “That growth is indicative of what has been happening in the radiology space as a whole—larger practices are becoming more sophisticated as the environment becomes more complex.”

That complexity took on an added dimension with the passage of the Patient Protection and Affordable Care Act (PPACA), which shifted health care organizations’ focus from volume to value. “It’s a whole new set of challenges to face,” Weber says. “We have to justify the value that we’re bringing to the market. For a private radiology practice that historically has been behind the scenes, for the most part, to become more client-facing represents a major change.”

Managing Change

CIRA has 17 hospital contracts throughout the central Illinois region, and while the practice reads for imaging centers as well, it currently has no financial interest in any freestanding facilities. “We do share our market with some competition,” Weber says. “It’s undeniable that a percentage of radiology has become a commodity, but as the definition of value in radiology becomes clearer, we can look at the care continuum and define for our partners where we’re having the most impact.”


“We know there’s a wave of change coming—the question is how will we be positioned when it arrives? Business intelligence gives us the information we need to guide our decisions.” –Patrick Ward, CIO

Doing so will be essential to maintaining competitiveness in the new care paradigm, Weber says: “It’s a matter of being able to package that information and bring it to hospital administration, showing them the effect diagnoses have on the long-term care of the patient and beginning the conversation about managing population health.”

To smoothly make the transition from a fee-for-service to a value-based approach, the radiology group will rely on business intelligence from its revenue cycle management company, Zotec Partners (Zotec), as well as its participation in Strategic Radiology to promote progress and measure its impact.

“We have multiple considerations to manage from the clinical, operational and financial perspectives,” notes Patrick Ward, CIO of the practice. “We know there’s a wave of change coming—the question is how will we be positioned when it arrives? Business intelligence gives us the information we need to guide our decisions.”

Defining Value

The next step for CIRA will be cross-referencing the information provided by Zotec against information from the practice’s hospital customers. “The business intelligence tools that we have can provide us with general and historical trends for treating patients,” Weber explains, “but what is absent from that is admitting information. To isolate how populations of patients are treated—and how radiology brings value to them—we need ordering information tied into billing information. Zotec is way ahead of the game in terms of its sophistication and ability to capture information that bridges the gap between why patients go to the doctor and what’s actually being billed.”


“By coalescing hospital data with billing data, we will have a meaningful, powerful dataset with which to sit down and negotiate truly value-based services.” –Eric Weber, CFO

Ward concurs. “Radiology is a downstream specialty, meaning we typically receive very segmented information,” he notes. “To see where we fit in the continuum of care, we need hospitals to give us more data. With ordering, scheduling, admission and discharge information available to us, we’d be able to make better decisions moving forward.”

Weber looks forward to developing those capabilities with Zotec. “They have a very powerful platform with a lot of proprietary control and the ability to customize reports,” he says. “They have the tools to give us predictive analytics and help us create forward-looking projections.”

Armed with robust information about the practice’s impact on patient care within its hospitals, CIRA will be in a strong position to maintain and grow its market share in spite of the major changes to come, Weber concludes. “Everyone is standing still on the contracts they have in place today, waiting to understand what’s coming,” he says. “They want to be able to understand what radiology is bringing to the continuum of care. By coalescing hospital data with billing data, we will have a meaningful, powerful dataset with which to sit down and negotiate truly value-based services.”