Interventional radiologists who neglect E&M visits risk losing more lucrative procedures
Interventional radiologists who neglect spending time evaluating and managing patients run the risk of losing out on more lucrative IR work, according to new research published Monday.
Delivering these complex procedures typically requires radiologists to evaluate patients beforehand and care for them afterward. However, amid pressure to boost productivity, many may prioritize procedural and diagnostic imaging services, which generate more immediate returns, experts write in JACR.
New research from the Neiman Health Policy Institute shows such neglect may risk further commoditizing the specialty and missing out on high-value services down the road.
“Our results show that clinical visits and procedural practice are interdependent,” lead author Eric Christensen, PhD, research director at the Neiman Institute, said in a Nov. 11 announcement about the study’s results. “Protecting IR office hours time in radiology practices is essential for delivering more complex, higher-value procedural care.”
The study utilized a nationally representative, 5% sample of Medicare data from 2022 to reach its conclusions. Altogether, it incorporated over 30,000 radiologists, who delivered 168,000 procedures and submitted over 18,000 claims for evaluation and management (E&M) work that year. Christensen and colleagues found that radiologists who dedicated 10% or less of their time to interventional care logged about 1.52 work relative value units (wRVUs) per procedure and 0.01 E&M claims per procedure. However, these numbers leapt to 3.08 and 0.66, respectively, for radiologists dedicating 90% or more of their time to interventional work. The findings align with previous studies, demonstrating that IRs who provide more evaluation and management services deliver more procedures with higher value (as measured by wRVUs).
“This study affirms that when interventional radiologists are afforded the time to evaluate and follow their patients, the complexity and value of the care they provide increases,” Robert A. Lookstein, MD, president of the Society of Interventional Radiology and a professor with the Icahn School of Medicine at Mount Sinai, New York, said in a statement. “Protecting dedicated IR time to see patients in office hours is not merely an operational concern—it is fundamental to preserving the physician-patient relationship that defines our specialty and enables IRs to deliver comprehensive, longitudinal care that measurably improves patient outcomes.”
The investigation was a collaboration between the Neiman Health Policy Institute and radiologists who are members of both SIR and the American College of Radiology. It’s part of a broader initiative by the two medical societies to demonstrate the value of interventional radiology, which became a distinct medical specialty in 2012.
As of 2022, fewer than 1,400 radiologists dedicated 90% or more of their time to interventional work, while nearly 2,900 spent over 50% of their day on IR duties. To put this in perspective, fewer than 1 interventional radiologist per U.S. county dedicates the majority of their workday to the subspecialty. Given staffing shortfalls, many practices are deploying nurse practitioners and other nonphysician providers to fill the gaps.
Such NPPs spent nearly 85% of their time on procedural work at practices that do not employ interventional radiologists, the study found. However, when working at IR-majority practices, the workload shifted, with NPPs spending about 86% of their time on evaluation and management duties.
“This study provides valuable insights for practice leaders, who should consider protecting IR office hours time and deploying NPPs strategically to expand E&M capacity under physician supervision,” Alan Matsumoto, MD, a professor of interventional radiology at the University of Virginia and chair of the ACR Board of Chancellors, said in the announcement.
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.