Subspecialty, complex patients up radiologist charges

The primary factors affecting the list price for radiologist services are the complexity of a patient's condition and radiologist subspecialization, according to research from the Harvey L. Neiman Health Policy Institute published online July 20 in the Journal of the American College of Radiology.

A team evaluated the 2014 Medicare Physician and Other Supplier Public Use File to identify the submitted charges -- the "list price" for radiologist services -- and payments for radiologists' services. The group found that the higher charges demonstrated consistent patterns of variation that are most strongly seen for those serving higher complexity patients, according to lead author Dr. Andrew Rosenkrantz.

"Additional higher price predictors for radiologists include having a subspecialized practice pattern, with interventional radiologists having the highest price markups," noted Rosenkrantz, a Neiman Institute affiliate research fellow, in a statement.

The mean charge-to-payment ratio was 4.2 among 26,715 U.S. radiologists. A greater charge-to-payment ratio was most strongly predicted for those serving higher-complexity patients and also among radiologists with a teaching institutional affiliation, in larger practices, and in rural areas, according to the researchers.

They also found that subspecialists had higher charge-to-payment ratios than generalists; breast imaging and interventional radiology had the greatest charge-to-payment ratios among subspecialties.

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