DRA has affected radiologists' salaries, study finds

Jun 3, 2009

The Deficit Reduction Act (DRA) of 2005 has negatively affected radiologists' salaries, although the severity of the law's impact varies across the U.S., according to results from a study published in this month's Journal of the American College of Radiology.

James Moser, Ph.D., of the American College of Radiology (ACR) in Reston, VA, and Dr. Dawn Hastreiter of Washington University in St. Louis found that the DRA's provisions directly reduced radiologists' income by 1%, although the indirect effect was probably higher, because 55% of the radiologists who participated in the study noticed private payors adopting similar cuts (June 2009, Vol. 6:6, pp. 408-416).

The data were gathered in 2007 via a random-sample telephone survey of ACR radiologist members from Arkansas, California, Georgia, Iowa, Louisiana, Michigan, Montana, New Jersey, New York, North Dakota, Texas, and West Virginia. Responses totaled 601 out of 3,596 contacted, for a response rate of 20%.

Moser and Hastreiter found that the average portion of income derived from all Medicare and private-payor technical component sources was 18%. As Medicare represents an average of 27.5% of a radiologist's medical income, and the average Medicare technical component payment cut for imaging modalities is 18.5%, the average reduction in a radiologist's total income from DRA caps and cuts is about 1%.

However, the researchers added that the figure does not illuminate the potentially larger percentage cut for those radiologists whose incomes depend on technical component billing, who have large Medicare patient bases, or who perform a lot of imaging that has been affected by the DRA (such as MRI).

Radiologists most vulnerable to DRA reductions because of higher technical component incomes included those who:

Owned imaging centers or were part of practices that owned imaging equipment
Lived in the Northeast
Were located in the suburbs of a large city
Were not at academic or government practices
Were 47 to 54 years old

Radiology practices dealt with the cuts in various ways, the most common being altering plans to acquire imaging equipment (particularly for modalities affected most by technical component cuts) and scaling back plans for future staff and office space. Moser and Hastreiter found that a practice's hours of operation and the types of imaging services offered were less likely to be affected by the DRA.

Finally, the survey data indicate that half of radiologists perform outside interpretations for imaging facilities that aren't directly part of their practices, with 40% of these cases possibly resulting in radiologists' not being reimbursed for the entire professional component. Moser and Hastreiter predicted that these types of contracts could also be affected by the antimarkup regulations that took effect in January of this year.

By Kate Madden Yee
AuntMinnie.com staff writer
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