The biggest challenges facing radiology business managers in 2025
Radiology Business Management Association President Pete Moffatt highlighted the critical challenges radiology practices face heading into 2025 in an interview with Radiology Business. Moffatt provided insight into persistent issues such as declining reimbursement rates, recruiting challenges and the role of artificial intelligence in transforming the industry.
Reimbursement cuts and their ripple effects
Medicare continued its trend of annual reductions in payments to radiologists with the 2025 physician fee schedule, which he said is practices' biggest challenge.
"Cuts to reimbursement, unfortunately, continue to be something that has an obvious negative impact on the industry," Moffatt said. "I just had an interesting discussion with a physician about two months ago where he told me he's 59 years old, he's working more hours now on a weekly basis than he did in his early 40s, and he's making less money. This is not an uncommon conversation or theme throughout the United States."
Workloads have increased because more patients are seeking care and radiologists need to put in longer hours to make the same amount of money they did a decade ago, he said.
"You just wonder where that line in the sand is where people just can't keep up with the amount of hours they're putting in. As a radiologist, we hear the term burnout quite often. Unfortunately, it's a lot of the same issues that people seem to be talking about in all sectors of the industry," he said.
Moffatt expressed hope that political changes and advocacy efforts might slow or even reverse these cuts in 2025.
"We obviously have a change taking place politically in the United States, and hopefully some good things will come out of that in the next year where we can at least slow the Medicare cuts. It would be great to see them reversed," he said.
Recruitment struggles in radiology
Recruitment remains a top concern as the shortage of radiologists continues to grow. With demand outpacing supply, recruiters are in high demand, evidenced by a 50%-70% increase in recruiter presence at RSNA since 2019. Rural practices face particularly acute challenges, often leaving physician positions vacant for six months, a year, or longer. Moffatt said it takes time to train a new radiologist, but the number of radiologists retiring is much higher than the percentage of graduates filling the gap.
He noted the large amount of people walking and having conversations in the RSNA recruiters row area of the expo floor as a sign of the times, where practices and health systems are willing to offer more pay and benefits for radiologists than they did a few years ago.
"Recruiters row over there looks like the place to be. If you're a physician searching for a job as a radiologist, you're still in the driver's seat. There's such demand out there," Moffatt explained.
The promise and pitfalls of AI
It is hard to have a conversation at RSNA without AI being mentioned. More than 200 vendors on the expo floor were showcasing at least one AI algorithm. The number of RSNA sessions discussing AI has multiplied from previous years. Moffatt believes this presents both an opportunity and a challenge.
Recent advancements in AI have introduced reimbursable codes for technologies like AI coronary plaque assessment, opening doors for more widespread adoption. However, concerns remain about the cost of implementing these systems and the learning curve for radiologists.
"We're talking to administrators and radiologists across the country about utilizing some of the new artificial intelligence technologies that are coming to market, and I think that's one of the real opportunities going into 2025 for the industry as a whole," Moffatt said. "The challenge seems to be that people are looking at these technologies and distinguishing what is really something of substance, rather than just a marketing tactic."
AI's potential to increase efficiency and reduce workloads is immense, but its adoption hinges on addressing practical barriers like cost, training and workflow integration. Practices need to balance how to pay for AI that is not reimbursed against whether the software will help them save money in other ways by boosting efficiency, improving diagnostic accuracy, or reducing turnaround times.
Looking ahead to 2025
Despite these obstacles, Moffatt remains optimistic about the future of radiology. Under his leadership, the RBMA has prioritized providing members with actionable insights and tools to navigate industry challenges.
"We're trying to bring value to our membership when we have conferences. We want to make sure we're bringing in speakers who offer usable information that people can take back to their organization to try to overcome some of these things.
As radiology enters 2025, the industry stands at a crossroads. Addressing reimbursement challenges, streamlining recruitment, and integrating AI will be key to navigating this complex landscape. For radiology business managers, finding innovative solutions to these persistent issues will remain a top priority.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com