If imaging volumes have only exploded over time...

[odyssey2]

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..why was there such a dramatic downturn in the job market during the recession in the late 2000s/early 2010s? I would think imaging orders would be fairly recession proof.

 

[SeisK]

They hadn’t spiked yet at that point. The market downturn was a result of 1) recession thinning investment portfolios, delaying retirement of older rads and 2) affordable care act causing significant reimbursement decreases for professional fees on studies, incentivizing increased pace and therefore further decreasing need for new hires. Before that radiology wasn’t as fast paced as it is now.

Now we’re as fast or nearly as fast as possible, and the culture of medicine is developing a dependency on imaging which will not be going away.

 

[Cognovi]

The reimbursement decline was multifactorial, not just the affordable care act. "It is generally known among radiologists that reimbursements for imaging have been sharply reduced by the Centers for Medicare and Medicaid Services (CMS). The largest cuts have resulted from mechanisms such as the Deficit Reduction Act of 2005, multiple procedure payment reductions, practice expense revaluation, and an increase in the assumed equipment utilization rate. Another recent addition to this list is code bundling" https://ajronline.org/doi/full/10.2214/AJR.13.11504

 

[maxxor]

Medicare cuts plus the 2008 great financial crisis blew us up.

Obamacare (2010) has altered the incentives to encourage massive consolidation and shifting of funds from the physician / professional side to the hospital / technical / facility side.

 

[vm26]

Medicare cuts plus the 2008 great financial crisis blew us up.

Obamacare (2010) has altered the incentives to encourage massive consolidation and shifting of funds from the physician / professional side to the hospital / technical / facility side.

Both posts are spot on. The golden age of radiology was when PACS increased efficiency and groups owning equipment was extremely profitable. Both have been targeted and slashed (death by a thousand cuts for CMS pro-fees)...Future of PP rad is uncertain. Unless group has strong payor mix and/or large hospital subsidization, this is a race to the bottom. Rads employed by HC systems are getting paid what they need in order to maintain recruitment/retainment (in part just using ridiculously high technical fees).

 

[maxxor]

Both posts are spot on. The golden age of radiology was when PACS increased efficiency and groups owning equipment was extremely profitable. Both have been targeted and slashed (death by a thousand cuts for CMS pro-fees)...Future of PP rad is uncertain. Unless group has strong payor mix and/or large hospital subsidization, this is a race to the bottom. Rads employed by HC systems are getting paid what they need in order to maintain recruitment/retainment (in part just using ridiculously high technical fees).

I think PP groups need to get back into technical if only to justify the future AI purchases they will need to keep making money.