A contentious contract standoff between Erlanger Health System and a radiology group was resolved Friday after both sides agreed to make changes to their agreement.

The deal with Tennessee Interventional and Imaging Associates reconfirms the group as Erlanger's exclusive radiology provider after weeks of uncertainty that began Jan. 7 when Erlanger handed the group a six-month notice of termination without cause.

After the termination notice, leaders from Chattanooga's medical community reached out to Erlanger's Board of Trustees to express support for the group and voice concerns that patient safety could be compromised if Erlanger lost Tennessee Interventional and Imaging Associates.

"I understand that the provision of notice and negotiations over the past month have created a level of angst both within and outside the health system," Erlanger CEO Kevin Spiegel said in a letter to Erlanger's Board of Trustees on Friday. "However, the action was absolutely necessary to guarantee that Erlanger continues to be a good steward of its public corporate resources, which I know you all appreciate."

Spiegel said the president of the radiology group, Dr. Steve Quarfordt, would be the best spokesperson for the group, but Quarfordt deferred comment to Dr. Justin Calvert, Erlanger's chief of radiology and a Tennessee Interventional and Imaging Associates partner.

"We are thankful to have reached an agreement to continue providing radiology services," Calvert said. "Our patients and the community depend on us for stability and continuity in the care we provide. We are humbled by the support, honesty and integrity demonstrated by Erlanger's physicians and members of the board."

The contract amendment withdraws the notice of termination, extends the notice period from 180 to 365 days and allows Erlanger to perform a baseline audit of the group's revenue cycle for 2018, which Spiegel said was necessary given that Erlanger pays a $4.2 million stipend to the group.

Tanner Goodrich, Erlanger's vice president of operations, said $4.2 million is a fair market value for radiology services, but Erlanger hopes its providers can increase operational efficiency and function without stipends in the future.

Also in the amendment is a provision that the group determine by April 30 whether it can provide consistent interventional radiology coverage at Erlanger East Hospital, which Goodrich said is an important support function of Erlanger's growing surgical services.

Spiegel said the option to cover Erlanger East using Dr. Blaise Baxter — an Erlanger board member who co-founded the group but resigned from the group last year — was in the hands of Tennessee Interventional and Imaging Associates, since the group has the contractual first right of refusal.

"It's not about what's fair. It's a contractual obligation," Spiegel said. "If they don't have the people to do it, they have to either waive that right or provide the service.

"Dr. Baxter is in the community. He's pretty much one of the most world famous neurointerventional radiologists," Spiegel said.

Letters sent to Erlanger's board members say Spiegel pressured the group throughout 2018 to rehire Baxter, who was appointed to Erlanger's board by Hamilton County Mayor Jim Coppinger in 2016.

Contact staff writer Elizabeth Fite at or 423-757-6673.