American Board of Radiology says it’s reducing user fees, but some skeptical it will help

The American Board of Radiology says it is reducing user fees for the field, but some are skeptical the shift will help relieve financially burdened providers.

ABR leaders revealed the news Wednesday in the latest edition of the Tucson, Arizona, nonprofit’s The Beam publication. President Vincent Mathews, MD, said ABR has not increased fees since 2016, during a time when inflation climbed 14% and the group used reserves to cover operating losses in 2020 and 2021 (and will again in 2022).

With that as a backdrop, the doc-certification group said it’s changing the fee for retaking exams to a one-time charge for all subsequent attempts. Plus starting next year, they’ll drop fees for subspecialty certification in diagnostic and interventional radiology, the total tally for IR initial certification, and re-exam charges in medical physics.

“The board will continue to ask ABR executive leadership to evaluate opportunities to reduce fees while maintaining the infrastructure needed to support a rigorous process of assessment and provide both value and service to our candidates and diplomates,” Mathews wrote Oct. 6.

Radiologists have cited high user fees as one of their chief complaints with the board. On average, physicians pay nearly $15,000 on certification during a 30-year career, one of the highest totals among medical specialties, a recent report found. Amid the pandemic, ABR switched to online examinations rather than in-person testing centers, a move stakeholders hoped would reduce fees further. But Mathews said online testing implementation, staffing and cybersecurity costs have all climbed, though in the long run, the remote model will be cheaper to administer and maintain.

Ben White, MD—a Texas neuroradiologist, blogger and ABR critic—said despite these modifications, he estimates total cost for initial certification will remain at $3,200, just divvied up differently. ABR’s fee structure, however, is now standardized across exams, decreasing the “otherwise ludicrous” subspecialty exam charges, White wrote Oct. 6. He also noted that the shorter, half-day certificate of added qualification is dropping in cost but believes the effect will be minimal.

“Before you get any warm fuzzies about their generosity, keep in mind that the CAQ exams comprise a relatively small proportion of ABR revenues since only ~200 people take them every year, and, meanwhile, [maintenance of certification] revenues continue to grow year after year,” White wrote.

In a subsequent social media post, White acknowledged positives of shifting from a membership-fee model (charging $640 annually until passing the Certifying Exam) to an exam-fee approach, collecting a one-time $640 application fee. This will delay payments so residents are doling out less early on and may make it easier to reduce fees down the line, he noted.

Marty Stempniak

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. 

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