Specialist
Former VP at Radiology Partners Inc
Agenda
- Key recent trends and developments
- COVID-19 impact on radiology sector
- Industry-wide bottom-line impacts and turnaround timeline
- Competitive differentiation between the big three – Radiology Partners, Envision and Mednax (NYSE: MD)
- 2020 outlook, including effects on teleradiology and strategic assessments
Questions
1.
Could you outline the key trends and themes you’re following in the US radiology market, and how those have changed since our last Interview [see Radiology Partners – Business Analysis & 2020 Outlook – 30 January 2020]?
2.
How would you say the coronavirus has impacted the radiology market? How have volumes trended through the pandemic beyond elective imaging? Could you comment on teleradiology?
3.
How would you anticipate volumes to have recovered thus far? Do you think we’ll return to pre-coronavirus levels? Over what time frame would you expect that recovery to take place?
4.
How detrimental would a second wave be to the market? How could that potentially affect volumes? You mentioned the labour impacts from junior radiologists being furloughed or let go. Could volumes again decline by 50-75% in early-hit areas such as New York and New Jersey?
5.
You mentioned a direct impact on radiology volumes from patients not going in for the imaging. Do you think the coronavirus has offered an opportunity to accelerate the adoption of teleradiology? Will the pandemic result in a greater onus on telerad R&D and implementation?
6.
How would you frame the financial impacts on larger and smaller practices of the volume dynamics you discussed, including on players such as Radiology Partners and Envision? Would there be a direct correlation between volume trends and top-line performance?
7.
How much ability might practices have to flex costs down in the current environment? What variable cost levers can be pulled in the near to mid-term? How should we frame the ROI shift, to return to your earlier point, given the volume limitations imposed by sanitation and disinfection requirements?
8.
Do you think the cost-cutting initiatives you identified could significantly mitigate some of the bottom-line headwinds resulting from the coronavirus?
9.
How could the coronavirus pandemic impact the radiology labour market in the long term, regarding areas such as costs, furloughs and use of locums?
10.
You predicted a degradation in reads and specialists having to move out of their comfort zones in the event of a new surge in cases. Could that scenario favour larger practices who could likely retain a more diverse array of specialists?
11.
What have you heard around physician appetite to work overtime or extend hours into the weekend, perhaps to mitigate the headwinds we’ve discussed? Should we have any labour-market concerns around physician burnout or early retirement as a result of the coronavirus?
12.
Do you think the labour market will stabilise to pre-coronavirus dynamics in 12-18 months, characterised by a significant radiologist shortage? How could those dynamics evolve, given your comments on recent graduates?
13.
Some commentators have suggested that hospitals might seek to dwindle down their radiology capabilities, given the CAPEX strain from imaging capital equipment. How viable is this move for small and mid-tier hospitals? How do you counterbalance the CAPEX strain some hospitals might feel under tighter budgets vs the margin profile of radiology departments?
14.
What’s your longer-term outlook on staffers such as Radiology Partners? Mednax is seeking to sell off their Radiology Solutions business. How do you think about its positioning in the market given the long-term dynamics?
15.
You predicted a stagnant M&A environment in the near term, given the capital constraints and drives to conserve cash. Do you expect an acceleration in M&A in the longer term, perhaps in a more normalised environment? Could there be cheaper multiples in the market? Could practices shut their doors before that opportunity arises?
16.
Are there any recent or upcoming regulatory changes that might have a significant impact on the US radiology market? You mentioned the surprise billing initiative earlier, but is there anything else you’d highlight?
17.
Could rising unemployment cause any payer mix shift, presumably towards government-pay or self-pay and away from commercial? How might that impact providers’ margins and bottom-line dynamics?
18.
Is there anything we haven’t spoken about regarding the US radiology market that you think is important to highlight?
