3 key questions about private equity’s impact on radiology
Physicians are posing three key questions regarding private equity’s growing involvement in diagnostic radiology.
Vrushab Gowda, MD, JD, and Joshua M. Liao, MD, MSc, shared their thoughts Thursday in the Journal of the American College of Radiology. They highlighted a March analysis, which found 12% of U.S. radiologists worked for private equity-backed entities as of 2023, up sharply from 1% in 2013.
Meanwhile, the number of radiologists working for hospitals and multispecialty groups also has increased, the authors noted.
“Some radiologists harbor deepening concerns about these trends, including moral distress, disincentives for quality and outcome performance, and loss of professional autonomy,” Liao and Gowda, with UT Southwestern Medical Center, Dallas, and Massachusetts General Hospital, Boston, respectively, wrote Aug. 14. “Underlying these concerns is the potential misalignment between profit motives (driven by [private equity] or hospital leadership) and clinical imperatives (pursued by imaging staff) that may give rise to a worrisome principal-agent problem.”
The March 2025 AJR analysis found that radiologists working in hospitals commanded 43% higher fees than peers in private practice, while private equity-backed groups saw 15.9% higher rates. Hospital-owned practices were more concentrated in the upper Midwest, and private equity proliferated in Alaska and the Southwest.
Gowda (a radiology resident with Massachusetts General Hospital) and Liao (a UT Southwestern internal medicine professor, MedPAC commissioner and member of the HHS Physician-Focused Payment Model Technical Advisory Committee) posed three questions to be answered from these studies:
- Are hospital-employed or private equity-owned radiology practices actually better-suited to achieve efficiencies and drive business growth?
- If private equity is so great, why aren’t more radiologists flocking to this employment model?
- Why do private equity-backed groups concentrate in certain geographies? Why are imaging prices better in some states? What regional market factors or regulatory impediments influence differences in radiology practice success?
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.