High deductible health plans, price transparency, consumerism and payor steerage are leading many hospitals to consider offering a value alternative in relation to imaging services. Imaging often serves as the “front door” to a health system. Patients go to an imaging center and are diagnosed with something that needs further treatment. If that study is read by the health system’s radiologists in a location flying the banner of the health system, where the record ends up in the health system’s EMR, that patient is going to be more likely to stay in the health system for further services. By moving forward with OIA and a value based outpatient strategy, a health system can secure downstream revenue while solidifying and improving its position in its market.