North Carolina’s oldest radiology practice dates back to the First World War and in one respect, says Mecklenburg Radiology Associates (MRA) president James C. Johnson, MD, the practice remains single-minded in a business strategy that has served it well.

“From its early beginnings, the practice has employed an approach of being aligned with our health system partners,” Johnson says. “We think it is important to be as engaged as possible with our health system partners.”

This tight alignment has resulted in some pivotal decisions over the years for the 100-year-old practice. “We made the decision to sell our outpatient mobile MRI business to one of our health system partners and close several imaging centers so that we are not competing and in order to be totally aligned with their strategies,” Johnson explains.

MRA is the sole provider of imaging and interventional radiology services at five Novant Health hospitals and its many imaging center locations in the Charlotte, NC area. In addition, the group also partners to provide imaging interpretation and IR services to Lake Norman Regional Medical Center, a CHS hospital in Mooresville, NC, and its imaging center.

Another related decision was MRA’s ongoing commitment not to outsource any clinical responsibility. “We staff 24/7/365, and we feel that our presence in all of our hospitals is the key to our relationship with the referring physicians,” notes Johnson. Johnson further states “If we outsource our primary clinical function, we don’t feel like we can effectively control the quality of the product offered to our patients and health system partners."

True Partner

The central tenet of MRA’s business model is service and quality, and the practice has worked hard to earn its role as a trusted strategic partner of the health systems that the practice supports through a high level of engagement. One MRA partner sits on the parent board of Novant Health’s Board of Directors and others hold positions on individual health system partner hospital committees. Partners also serve as department directors at the hospitals and imaging centers.

“We have physicians on several lower boards within Novant Health and also on committees within CHS ” Johnson shared.  “Our health system partners recognize our commitment to their respective missions and see us as a true partner. We think it is a factor in our success—being in such tight engagement and alignment.” 

Johnson often reminds his radiologists that service and quality are MRA’s true products. “This is what we are really selling to our referring physicians, our patients, and our health system partners,” he emphasizes. “Interpretation of studies can potentially be viewed as a commodity. What we sell is service and quality. That is the factor that can differentiate us.”

MRA also maintains a close working relationship with another private radiology practice that is closely aligned with Novant Health in the Winston-Salem, NC, market.  This is a further step it took to align with one of its health system partners.

Quality and Independence

In support of quality, MRA hires the best possible candidates, ensures that all subspecialties are covered, and internally monitors quality. To prepare for value-based health care, however, the practice has been giving a lot of thought to the metrics and benchmarks it needs to demonstrate that quality.

“We realize that we have moved into this new realm, and we want to have a means to actively measure and document our quality and service,” Johnson shares. “One of the main attractions of Strategic Radiology is its focus on the PSO and being able to evidence quality—we frequently update  our partner health systems regarding what we are doing for them, but we want data and metrics that we can show to demonstrate improvement.”

MRA attended its first Quality Forum and quarterly Membership Meeting in March. “We already feel a strong alignment with Strategic Radiology because we share the same goals that Strategic is focused on,” Johnson shares. “Attending the March Quality Forum made us see how much work the other people in Strategic have already done. It is a very natural fit, and to be honest, we are thankful to have found SR. I don’t know if similar benefits exist elsewhere.”

In addition to participating in SR’s PSO and Quality Forums, Johnson reports that MRA is eager to engage with Strategic Radiology’s Collaborate forums, which include active communities for many key practice domains. “We are looking forward to the sharing of best practices,” he notes. “Not just clinical, but also business, professional, and other areas within the practice.” 

Last but not least, MRA has a strong affinity for Strategic Radiology’s commitment to independent radiology groups. “We are intent on remaining independent, and we have no interest in pursuing private equity or other forms of buyout,” Johnson states. “Our group realizes that each group situation is different, but private equity or other forms of buyout would be a short-sighted strategy for us—and for a lot of groups, we think.  We have a long-term strategy of keeping our focus on alignment, engagement, service, and quality.”

Growing Market, Growing Health System

At soon to be 52 radiologists, MRA would be considered a large practice, but it has never pursued growth for the sake of growth. Instead, it has grown organically, in parallel to the growth of the Charlotte, NC market and its health system partners.

“We are fortunate to be in a growing area with growing health care systems that are great partners with us,” Johnson says. “In the last five to seven years, growth is accelerating, so our  challenge has been to make sure we are responding in a timely fashion to the organic growth that is taking place within our service area.”

As a highly engaged practice, active in both state and national organized radiology, MRA is doubling down on its alignment strategy by joining Strategic Radiology.

“Engagement and alignment define our practice,” Johnson asserts. “We consider that to be an integral part of our business model.  Added value above and beyond interpreting studies is our goal and our offering to our health system partners."