Enhancing Your Practice's Revenue - California Orthopaedic ...

your needs. Most will participate in writing a Request forProposal (RFP), reviewing specifications provided by vendors,and negotiating with vendors.If you cannot afford to purchase an MRI, you may wishto consider a lease arrangement. However, regulations onleasing arrangements have been tightened in recent yearsand this trend is likely to continue in the future. Consultationwith a healthcare attorney is recommended. For moreinformation about leasing vs. purchase, see # 5 in the TenTop Tips Appendix.DEXABone densitometry testing for patients at risk forosteoporosis is recommended by the AAOS. Generallyorthopaedic offices that have DEXA machines do so forpatient care reasons and not because DEXA is highlyprofitable. Medicare and most commercial payersdrastically cut reimbursement for DEXA as a result of theDeficit Reduction Act of 2006. Current reimbursementin most locations is less than half of what it was in thatyear. That said, it is often possible to find used DEXAequipment at a relatively low price.Many orthopaedic offices have little interest in managingthe patients who are diagnosed with osteoporosis and thereforeconsider DEXA more appropriate for a family practicesetting. Some, however, view DEXA scanning as a servicethat rounds out their array of musculoskeletal services. SeeChapter 12: Social Media Marketing.UltrasoundUltrasound in an orthopaedic office is a fairly recentphenomenon and was driven at least partially by PlateletRich Plasma (PRP) therapy. Ultrasound for guided needleplacement is often reimbursable. As the emphasis forproving quality care increases, procedures under ultrasoundmay become a standard of care, especially when they areperformed by mid-level providers in connection withinjections.Ultrasound also has diagnostic capabilities and can beuseful for physicians who do not have space for MRI anddo not want to have patients wait for imaging. Finally, withthe increase in high deductible insurance plans, there is anincreasing number of patients who are unwilling to have anMRI for financial reasons.Ultrasound machine prices vary widely depending onfeatures and accessories. New ultrasound equipment thatis appropriate for orthopaedic offices will generally costbetween $30,000 to $50,000. As with MRI, accurate estimatesof volume and reimbursement are critical to profitability.Final ThoughtsFor orthopaedists, the history and physical has longbeen key to the successful diagnosis of patients withmusculoskeletal patients. Traditional film X-rays providedthem an additional diagnostic tool. Imaging technologycontinues to evolve, allowing orthopaedists to diagnosediseases, disorders and conditions more quickly and witheven greater accuracy. The result is a win-win situation forpatients and doctors alike.Contact: Dale, Reigle, MS: dreigle@rmodocs.comThomas Grogan, MD: tjgrogan@aol.com© 2011 American Academy of Orthopaedic Surgeons25