ACR changing its accreditation process in response to corporate consolidation
The American College of Radiology is voicing concern over the rapid consolidation of practices, which has left fewer than half of radiologists working in independent private practice, according to CEO Dana Smetherman, MD, MPH, MBA.
"One of the big trends we have seen is consolidation, but it's really not just confined to radiology or even healthcare," she said in a recent interview with Radiology Business. "People are looking for economies of scale, given inflation and other economic pressures and regulatory burdens. It gets very hard for a small business, and ultimately some of our independent private practices are really small businesses just like any other small businesses."
Traditionally, private radiology groups were made up of 10 to 15 physicians. Even a practice of 30 radiologists was once considered large. Today, however, it is common to see hundreds of radiologists working under the umbrella of a corporate-owned practice, academic medical center, or hospital-based healthcare system. Private equity-backed consolidation has accelerated that shift, fundamentally changing the landscape of how radiology is delivered across the country.
The changes also affect how ACR administers its accreditation programs. In the past, practices seeking accreditation might have had only a single outpatient imaging center and a hospital contract. Now, many operate dozens of imaging facilities across multiple states, all staffed by the same core group of radiologists.
"We realized that our systems had not really adapted to that change," Smetherman said. "We were treating our facilities that we were accrediting as though they were still individual small practices and not a larger group of 20, 30 or 50 different facilities."
The college addressed this by introducing ACR Pulse, launched at its 2025 annual meeting in May. This helps a healthcare system to look at all ACR accreditations in one place at one time. The platform provides consolidated oversight for healthcare systems with multiple accredited sites, enabling them to track renewals across facilities in one place.
"See when the different things are coming up to have their accreditation renewed, make it easier for them to track, make it easier for them if it's the same 100 radiologists that are working at 10 different sites. With the radiologist shortage, this is how more and more practices are operating," Smetherman explained.
The response from health systems was swift. ACR sent out about 400 emails about the new program to its largest organizations that had the most sites accredited. Within days, over 240 of them had responded and said the effort has the potential to reduce administrative burdens considerably. These sites quickly created accounts and nominated somebody to be the primary contact to begin the streamlining process.
"It's been really exciting to see that that was so successful and solved a pain problem. We wanted to make it less of a burden because everyone is just so busy," Smetherman said.
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: [email protected]