Radiology Digest – October 25, 2022

October 20, 2022

Radiology Digest: News from the week of October 25, 2022.
Private Practice IRs Out-earn Academic Peers, but Fuller Comparison Suggests a Wash on Quantifiable Pros and Cons
By Dave Pearson | October 19, 2022 | Included in Radiology Digest – October 25, 2022

Interventional radiologists in private practice work slightly fewer hours per week than their academic counterparts, 50 vs. 52 (median), yet they earn considerably more per year—$573,000 vs. $451,000 (by median figures for tenured and partner radiologists).

The academics turn the tables in median starting salaries, edging out the privates $380,000 to $374,000 while also working fewer weekly call days (five vs. six).

The findings are aggregated from 357 members of the Society of Interventional Radiologists who completed a 60-question survey. Respondents represented 258 practices—100 academic, 158 private—in 40 states.
The project is described in a study published online Oct. 17 in JACR [1].

Corresponding author Lola Oladini, MD, MBA, of Stanford and colleagues further found private IR practices accruing significantly more work relative value units from diagnostic reads than academic groups.

Here the privates collectively attributed 26% of their total wRVU output to diagnostic interpretations while academics reported a cumulative 7%.

Also, academic practices indicated significantly higher case percentages of interventional oncology and complex hepatobiliary intervention, while private practices had significantly higher percentages of musculoskeletal intervention.

The only other metric showing marked separation between the two fields was in clinical fulltime equivalents. Here, unsurprisingly, academic IR groups reported significantly more cFTEs—five to private practices’ three.

The authors surmise this difference largely owes to nonclinical duties for academicians, not least teaching and research.

To read more, go to Radiology Business.


Outpatient Imaging, Teleradiology Shape U.S. Radiology Market
By Amy Thompson and Arun Gill | October 19, 2022 | Included in Radiology Digest – October 25, 2022

The healthcare market is witnessing a dynamic shift in how and where patients want to receive care, with the flexibility and convenience of outpatient settings driving a greater utilization of outpatient imaging and teleradiology services. This trend is most prevalent in the U.S. market.

This change is being driven predominantly by changes to reimbursement and payers pushing non-emergency imaging to the outpatient setting, as well as the legacy of the pandemic having its part to play. Impacting both image acquisition, image reading, and services, this has led to market growth and vendor opportunities within traditional outpatient imaging providers, such as imaging centers and radiology reading groups, as well as teleradiology groups.

Productivity and efficiency
Despite changes to reimbursement driving patient care toward the outpatient setting, the value of reimbursement (in terms of imaging reads) continues to diminish. This entrenches the importance of products and tools that enrich a provider or radiologists’ efficiency and productivity, whether that is increasing patient throughput, or faster reading and reporting. As such, the outpatient market is, typically, the first to adopt innovative technology, such as artificial intelligence (AI), analytics, and public cloud architecture.

Such innovation paves the way for imaging IT vendors’ future success; to capitalize on this growing market, investment will be required to re-architecture PACS and RIS platforms to utilize the scalability and elasticity of a cloud-native deployment. This demand will continue to intensify as the provider market undergoes further consolidation, and outpatient and teleradiology networks become geographically dispersed. Imaging IT vendors have begun responding to this market trend.

To read more, go to Aunt Minnie.


House Progressive Bill Wants to Take Medicare Out of Medicare Advantage’s Name
By Robert King | October 13, 2022 | Included in Radiology Digest – October 25, 2022

New legislation from two House progressive lawmakers wants to change the name of Medicare Advantage (MA) to “alternative private health plan,” the latest criticism of the program ahead of open enrollment.

The Save Medicare Act (PDF), introduced Thursday by Reps. Mark Pocan, D-Wisconsin, and Ro Khanna, D-California, argues that MA plans mislead seniors. The introduction of the bill—right ahead of open enrollment that starts Saturday—shows that while MA traditionally has wide bipartisan support, there remains opposition among more progressive lawmakers. 

“Medicare Advantage is just private insurance that profits by denying coverage and the name is being used to trick seniors into enrolling. That’s not right,” said Khanna in a statement. “This bill will prevent these private insurers from labeling themselves as Medicare and allow us to focus on strengthening and expanding real Medicare instead.”

The legislation would relabel MA as alternative private health plans and significantly fine any insurer that uses Medicare in plan titles or advertisements. 

Pocan said in a statement that Congress should instead work on expanding traditional Medicare to include dental, vision and hearing benefits that are offered by MA plans.

“These non-Medicare plans run by private insurers undermine traditional Medicare,” he said. “They often leave patients without the benefits they need while overcharging the federal government for corporate profit.”

The bill doesn’t appear likely to make it through the House, where more than 80% of lawmakers recently wrote a letter signaling their support for the growing program. However, it underscores criticism that progressives have of MA, especially private insurers’ role in it and reports of overspending. 

To read more, go to Fierce Healthcare.


Patients’ Out-of-pocket Expenses Up 123% for Some Imaging Modalities
By Hannah Murphy | October 13, 2022 | Included in Radiology Digest – October 25, 2022

Patients’ out-of-pocket expenses have climbed exponentially in recent decades, with some imaging exams costing 123% more today than in the year 2000 [1]. 

Mean out-of-pocket costs have risen by 89.8% from 2000 to 2019, with some exams hitting patients in their wallets more than others. This and other revelations, including what factors impact OOP expenses the most, were shared recently in the Journal of the American College of Radiology.
The new paper’s corresponding author Gelareh Sadigh, MD, with the University of California Irvine, Division of Neuroradiology, Department of Radiological Sciences, and colleagues explained that although increased imaging utilization has been a driver of rising healthcare spending, recent payment cuts have placed medical imaging at the bottom of the long list of contributing factors. Nevertheless, Sadigh and colleagues suggested that medical imaging still represents a financial burden to many patients, stating that “more recent concerns have been raised about how increasing co-pays and deductibles for imaging contribute to patient financial hardship.” 

After analyzing 229,010 imaging-focused encounters, the researchers found that mean costs for mammography, general radiography and US increased 14.5%, 24.5% and 40%, while CT and MRI costs decreased by around 15%.  

This did not, however, decrease patients’ OOP expenses. In fact, OOP expenses skyrocketed for all these modalities except mammography, for which a decrease in OOP costs was observed (this is likely attributed to more widespread screening guidelines and coverage mandates). The authors shared that mean OOP costs for radiography, US and CT/MR increased 81%, 123.2% and 61%, respectively. 

To read more, go to Health Imaging.
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