Summary: Consolidating radiologists into larger or multispecialty practices enhances subspecialization and negotiating power, driven by shifts from small to large and radiology-only to multispecialty practices, with a 17.3% increase in radiologists from 2014 to 2023.

Key Takeaways:

  1. The consolidation of radiologists into larger or multispecialty practices enhances subspecialization and improves negotiating power with payors.
  2. From 2014 to 2023, the number of radiologists increased by 17.3%, while radiologist-affiliated practices decreased by 14.7%, indicating a shift from small to large and radiology-only to multispecialty practices.
  3. The study suggests that economic incentives and legislative changes may be driving the consolidation trend in radiology practices.

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The consolidation of radiologists into larger or multispecialty practices could enhance subspecialization and improve negotiating power in payor contracting, according to a new study appearing in the American Journal of Roentgenology (AJR).

Decrease in Radiology-Only Practices

“An overall decrease in the number of radiology practices and concurrent growth in the number of radiologists was mirrored by shifts from small toward large practices and from radiology-only toward multispecialty practices, consistent with ongoing practice consolidation,” notes Eric Christensen, PhD, the director of Economic and Health Services Research for the Harvey L. Neiman Health Policy Institute.

In their AJR accepted manuscript, Christensen and colleagues analyzed CMS data from 2014 to 2023 to identify all radiologists and their affiliated practices. These practices were categorized as radiology-only or multispecialty, with multispecialty practices further classified as radiology-majority, other-specialty-majority, or no-majority-specialty. Practices that ceased operations were also noted. Temporal shifts were assessed to infer consolidation patterns.

Surge in Large Radiology Practices

From 2014 to 2023, the number of radiologists increased by 17.3%, while radiologist-affiliated practices decreased by 14.7%, radiology-only practices decreased by 31.8%, and radiologist-affiliated multispecialty practices increased by 12.3%. Practices with 1–2, 3–9, 10–24, 25–49, 50–99, and ≥ 100 radiologists changed by -18.7%, -34.4%, -25.2%, 33.2%, 121.6%, and 348.5%, respectively.

“While determining causes of consolidation were beyond this study’s scope,” the AJR authors add, “the shifts may relate to economic incentives and legislative changes favoring large multispecialty practices.”