It’s no secret that US radiology’s traditional private-practice model has been slowly fading away, but new numbers published in AJR illustrate the magnitude of the shift. The number of radiologist-affiliated and radiologist-only practices has dropped, even as the total number of US radiologists has gone up.
Radiology has long prided itself on a cozy business model in which radiologists banded together as owner-operators of small private-practice groups that contracted their services with hospitals.
- This model has had many benefits for radiologists, but it’s begun to fray in the face of competitive threats like teleradiology providers, health system consolidation, and large national radiology groups like Radiology Partners.
Many radiologists have chosen to switch rather than fight, selling out to national groups or taking positions as employees within health systems.
- Meanwhile, some practices that want to stay independent are finding strength in numbers by joining with other like-minded groups or seeking out multi-specialty medical groups.
In the new study, researchers from the ACR’s Harvey L. Neiman Health Policy Institute analyzed CMS data from 2014 to 2023, tracking not only changes in the number of US radiologists but also their type of employment, finding …
- The number of radiologists grew 17%, from 30.7k to 36k
- But the number of radiologist-affiliated practices fell 15%, from 5.1k to 4.3k
- The number of radiology-only practices fell 32%
- The number of small radiology practices fell, with the decline varying by practice size: 1-2 radiologists -19%, 3-9 radiologists -34%, and 10-24 radiologists -25%
- The number of large practices jumped, with the biggest increase – 349% – at very large practices (over 100 radiologists)
- The mean number of radiologists per practice shot up 84%, from 9.7 to 17.9
Why the shift? The researchers theorized that much of it was driven by federal policy and reimbursement changes that incentivize consolidation, mostly to spread the risk and cost of compliance with various regulations like ACA and MACRA.
The Takeaway
There’s no question that radiology is changing – the question is what impact the changes will have on how radiologists perceive their work. The old guard may choose to rage against the dying of the light, while younger generations embrace the new model and its benefits for both professional careers and patient care.
