Radiology Associates PA of Little Rock is the biggest radiology group in the state, but since its founding almost 80 years ago, the group’s service area hadn’t extended outside of central Arkansas.
Not until last year, that is, when RAPA began a major expansion that included finally breaking into the state’s northwest corner.
To the 21 hospitals, outpatient clinics and imaging centers RAPA was already serving, the group has added 13 locations since January 2006, all but three in Northwest Arkansas.
That expansion included hiring 12 doctors, bringing its total to 47. Some of these doctors were hired right out of the hospitals and communities RAPA now serves.
For instance, RAPA hired Dr. Douglas Elliott and Dr. Herbert Hamilton in January 2006 to cover interventional radiology services at several of RAPA’s new Northwest Arkansas locations.
Having previously worked with some of the providers RAPA now serves, Elliott and Hamilton already had established reputations as highly qualified radiologists, according to Penny McClaine, CEO of Siloam Springs Memorial, which contracted with RAPA in November.
McClaine said the opportunity to use the services of these expert radiologists, coupled with RAPA’s stability, a quality resulting from having been in business for decades, led her to decide to replace her hospital’s radiology staff with RAPA.
“It was a good way for us to get high-quality radiologists in here,” McClaine said.
Offering round-the-clock support of specialists and sub-specialists through the cost-saving miracle of Internet communications, RAPA also forged a contract in July to cover Mercy Health System’s radiology needs at St. Mary’s Hospital of Rogers and Mercy Health Center of Bentonville. In that case, however, RAPA hired five radiologists with Mercy Health, a move that Mercy Health CEO George Flynn said strengthened services the provider was already offering.
RAPA is negotiating a long-term relationship with Northwest Health System to offer radiology services at its three locations: Northwest Medical Center of Bentonville, Northwest Medical Center of Springdale and Willow Creek Women’s Hospital at Johnson.
RAPA has been providing interventional radiology services through Elliott and Hamilton at all three locations since Jan. 1. RAPA chief administrative officer Taunia Stadter said RAPA is working on a merger with Northwest Health System’s radiologists who provide general radiology services for the Springdale medical center and Willow Creek. An announcement of that merger could come as early as April.
RAPA is not currently engaged in discussions with Northwest Health regarding a long-term contract for general radiology services at the Bentonville medical center, Stadter said.
On Feb. 6, Triad Hospitals Inc. of Plano, Texas, which owns Northwest Health System, announced a $4.7 billion merger agreement with a private equity group that includes CCMP Capital Advisors and GS Capital Partners.
Aside from hospitals, RAPA also partnered with six outpatient clinics and imaging centers since January 2006.
RAPA also teamed with Rebsamen Medical Center of Jacksonville to open a new imaging center in Cabot in June 2006.
The Group has also seen some administrative changes.
Stadter became CAO in February 2006. An attorney by training, Stadter also brought 20 years of experience in all aspects of health care administration. She replaced Jerry Linebarger, who retired one month early after 17 years in that position.
In August, RAPA hired Michael Howell as chief financial officer. Howell previously worked for 12 years at Practice Plus, a subsidiary of Baptist Health of Little Rock.
RAPA also created a new director of marketing and communications position and in January hired Elissa Dixon to fill it. Stadter said the position was necessary as RAPA continued to grow around the state.
And in February the group announced board elections. Dr. Andrew Getzoff, an interventional and neuroradiology specialist at RAPA since 2001, was elected to serve a 12-month term as chairman, replacing Dr. James McDonald.
High-tech and Local
In its more than 80 years of operation, RAPA has developed a reputation as an innovator and early adopter of new technologies. In the early 1980s, for example, RAPA owned and operated the first MRI scanner in Arkansas, which was among the first 100 clinical MRI installations in the world.
“In the old days, all of the images were printed on film. Now most of what we read is off of a computer screen, and because of that you can transmit that image anywhere you want to, anywhere that the Internet goes,” Getzoff said.
In this way RAPA is able to keep as few as one doctor on site performing basic tests and readings, and that doctor has all the doctors at RAPA’s central office to consult with on more complicated procedures and readings. Stadter said that’s how RAPA is exporting the expertise specialist and sub-specialist radiologists to rural providers and patients.
Those same telecommunication advances driving RAPA’s expansion also allow competitors to cut costs by outsourcing work to companies in other states and countries, where the images can be read in different time zones.
That’s something RAPA has no plans to do. Getzoff said RAPA is one of the last radiology groups in Arkansas to read all of its own imaging. And it’s still able to have someone on call every hour of every day.
Getzoff said that kind of personal interaction is especially appealing in Arkansas, a state in which a “two degrees of separation” rule is likelier to apply than the usual “six degrees.”
About half the radiology groups around the country are outsourcing their readings, but not all of that work is going to huge, impersonal companies overseas, according to Dr. Steve Nokes of Radiology Consultants of Little Rock, RAPA’s main central Arkansas competitor.
Nokes said Radiology Consultants uses a small California company called 24/7 Inc. for its readings between 2 and 7 a.m. Nokes said he feels comfortable collaborating with 24/7’s three-member team of Harvard-trained, Arkansas-accredited radiologists.
Preventing to Curing
As RAPA expands, Getzoff said, the group is also offering more interventional radiology services. RAPA currently has 10 interventionalists on staff.
Interventional radiology includes more invasive procedures in which the doctor inserts tubes into a patient’s arteries, veins or chest.
These include tests like biopsies or angiograms, in which the radiologist is filling his or her more familiar role as diagnostician.
But Getzoff said some interventional radiology includes actually treating, not just identifying, a health problem.
For example, Getzoff has specialized in a procedure known as aneurism coiling, a service he started offering two years ago.
Getzoff said this procedure can be more effective than open-skull surgery for deep-brain aneurisms. RAPA performs about 20 of these procedures a year.