News | Business | August 15, 2017

Patient Complexity, Subspecialization Impact List Prices for Radiologists' Services

Neiman Institute study finds prices are generally higher for subspecialists, radiologists who serve higher-complexity patients

Patient Complexity, Subspecialization Impact List Prices for Radiologists' Services

August 15, 2017 — A new study by the Harvey L. Neiman Health Policy Institute finds that patient condition complexity and subspecialization are primary factors affecting radiologist services list price variation. The researchers evaluated the 2014 Medicare Physician and Other Supplier Public Use File to identify submitted charges (“list prices”) and payments for radiologists’ services. The report is published online in the Journal of the American College of Radiology (JACR).

“The results found that the higher charges for radiologists’ services demonstrate consistent patterns of variation and are most strongly seen for those serving higher complexity patients,” said Andrew Rosenkrantz, M.D., MPA, lead study author and a Neiman Institute affiliate research fellow. He also added that, “Additional higher price predictors for radiologists include having a subspecialized practice pattern, with interventional radiologists having the highest price markups.”

Rosenkrantz and his colleagues found that among 26,715 radiologists nationally, the mean charge-to-payment ratio was 4.2. A greater charge-to-payment ratio was most strongly predicted for those serving higher-complexity patients. A higher charge-to-payment ratio was also observed among radiologists with a teaching institutional affiliation, in larger practices and in rural areas. Subspecialists were observed to have higher charge-to-payment ratios than generalists. Among subspecialties, the greatest charge-to-payment ratios were for breast imaging and interventional radiology. 

“As price transparency initiatives expand, radiologists should be aware of how and why their list prices compare with local and national benchmarks,” noted Richard Duszak, M.D., FACR, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University and senior affiliate research fellow at the Neiman Institute.

For more information: www.neimanhpi.org

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