Segmenting the Radiology Market

Following up from my prior post on the life of a radiology procedure, I figured I would try to define the radiology market a bit.  Segmenting any market is always tough because there are so many combinations and variations.  My understanding is certainly not complete so there is bound to be errors in what I describe here.  Any feedback on how I can make this more accurate would be appreciated.

Patient Facing Organizations

Luminary Hospitals (~5% of the market)
A luminary hospital is one that is well known in the industry for one or more of the following reasons:

1. Hospitals associated with educational institutions that train radiologists (e.g. Stanford, MGH)
2. Hospitals that are actively engaged in research activities 
3. Hospitals that provide world class service and outcomes for specific procedures or diseases (e.g. MD Anderson Cancer Center, Intermountain Healthcare, Mayo Clinic)

Individuals that work for luminary hospitals are highly sought after by vendors as they provide validation of their strategy and products.  Luminary hospitals tend to lead the industry with respect to innovation and IT solutions.  They often have very strong IT teams and visionary individuals that can apply technology to solve clinical problems (e.g. Dr. Paul Chang, Dr. Paul Nagy, Dr. Eliot Siegel).  The quality of care at luminary hospitals is considered the best you can get.

Mid Level Hospital (~20% of the market)
A mid level hospital is one that is not considered a luminary but can be quite large and provide specialty services.  There is a wide range of IT sophistication at the mid level hospitals.  Some have internal IT teams while others will outsource the entire IT team to another company such caretech.  The actual quality of care received from mid level hospitals typically ranges from good to excellent.

Community Hospital (~30% of the market)
A community hospital is what you find in smaller cities and rural regions.  Community hospitals are quite small, provide limited services and tend to provide below average quality of care.  The level of IT sophistication is generally quite low.

Imaging Centers (~20% of market)
Imaging centers are organizations focused on radiology imaging only.  They typically own their own equipment and have their own radiologists read the studies.  They generally charge less than hospitals and range in quality.  They often provide services at or below a mid level hospital.  Imaging Centers are highly focused on reducing operational costs and tend to view products from that perspective.  The largest Imaging Center is RadNet, you can find a list of them here.

VA (~10% market)
The VA takes care of US veterans and have hospitals throughout the US.  They are organized into regions called a "VISN".  See a map of the VISN's here.  One interesting thing about VA hospitals is they were the first in the USA to have a true EMR which is called VISTA and open source.

Department of Defense (~5% market)

The Department of Defense (or DOD) provides healthcare for government officials and active service personnel.  They have very high security standards which vendors must pass before they can sell to the DOD.  

Other Related Organizations

Private Practice Radiology Groups 

A private practice radiology group is a company that provides diagnostic interpretation for any of the above hospitals.  Radiology groups range in size from an individual radiologist to a group of 50+ radiologists.  Radiology groups typically perform reading services for multiple hospitals.  You can find a list of the top private practice radiology groups here.

Teleradiology Services
Teleradiology services came in to being to provide after hours reading for hospitals.  Smaller radiology departments have trouble covering late night or weekend reads and contract with a teleradiology service to do this for them.  The largest teleradiology service company is vRad

Integrated Delivery Networks
An integrated delivery network (or IDN) is an organization that consists of many hospitals that are integrated to provide more cost effective healthcare.  IDN's have come into being over the past 15 years as midlevel hospitals have struggled to stay profitable.  IDN's are quite large and therefore have large IT groups and high expectations regarding product scalability, availability and integration.  You can find a list of the top IDN's here.

Group Purchase Organizations

Group Purchase Organizations (or GPOs) are organizations that have hospitals as members that group up to get better pricing.  If a vendor can get on the approved list of a GPO, it can make sales much easier at the cost of a lower sales price.  A list of the top GPO's can be found here.

Mobile Providers
A mobile provider has CT and MRI scanners on trucks that can be driven to a given location to increase capacity at a hospital.  The biggest player in mobile MRI is Alliance Healthcare.