Radiology practices that own their imaging equipment less likely to face closure
Radiology practices that own their imaging equipment are less likely to face closure, according to new Neiman Health Policy Institute research published Tuesday.
Economic and health policy factors can drive consolidation, with financial pressure forcing physician groups to seek shelter in larger organizations. Researchers hypothesize that owning the imaging machine—allowing practices to collect the “technical component” of reimbursement, in addition to the “professional” fee for reading the scans—could shelter groups from market forces.
To test their theory, Neiman experts analyzed fee-for-service Medicare claims and taxpayer ID numbers, spanning 2008 to 2021, sharing their findings in JACR. Based on their analysis, practices that can collect these extra revenues appear somewhat safer from fears of going out of business.
“We observed lower likelihood of radiology practice closure for those with a higher [technical component] share, a pattern consistent across different categorizations…,” lead author Eric W. Christensen, PhD, research director of the American College of Radiology-backed policy institute, and colleagues wrote Sept. 29. “A higher practice [technical component] share may thus provide some protection against practice closure.”
Altogether, there were nearly 31,000 “practice years”—representing how long a group had been in business—meeting the study’s selection criteria. The average technical component billing share was about 29% and practice closures accounted for 5% of practice years. The study sample was heavy among practices employing 2 to 9 radiologists (62%) and groups that only operate in radiology (70%), rather than multiple specialties.
About 36% of practice years had no technical component billing. Another 2% had about 50% to 59% of the technical component billing share. And about 9% of the sample had 100% of their billing include the technical component.
Deeper analysis showed that a practice closure was about 17% less likely, if it had at least some technical component billing. A 50% to 100% share was associated with 23% lower odds of closure compared to practices with no billing on the equipment side. Across the study models, larger practices demonstrated progressively lower odds of shuttering. For instance, groups with 10 to 39 or 40-plus radiologists were less likely to close than those with fewer than 10.
As further proof of their hypothesis, Christensen and colleagues highlighted a 2026 survey of 360 medical practice leaders. About 79% of those polled reported that technology was either very or extremely important to their organization’s ability to remain independent.
“While we cannot assert causation, practices with high shares of [technical component] billing seem somewhat protected against forces driving consolidation,” the authors charged. “Why this is the case is unknown but could be related to higher revenue or better negotiating positions.”
Read more, including potential study limitations, in the Journal of the American College of Radiology.
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.