Browsing by keyword "radiologists"

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    • How Radiologists Are Paid: An Economic History, Part I: The Fight for Independent Billing
      Levy, Frank; Rosen, Max P. (2020-03-20)
      In this four-part work, the authors review the economic history of how radiologists are paid, from the fight for independent billing in the 1960s to the impact of advanced imaging technologies on radiologists' incomes in the 1980s to the "bubble years" of the 1990s and to the end of the bubble in the first decade of the 21 century. The authors begin in this first part with the connections among a radiologist from Arkansas, a congressman, and the passage of Medicare, the program that gave radiologists the right to bill independently and gave the federal government a big role in health care spending.

    • How Radiologists Are Paid: An Economic History, Part II: Advanced Imaging and Radiologists' Incomes
      Levy, Frank; Rosen, Max P. (2020-03-24)
      The advent of the CT scanner in the early 1970s removed much, if not all, of the morbidity and discomfort previously associated with diagnostic imaging studies. Throughout the 1970s and 1980s, advances in CT technology allowed radiologists to scan "better and faster." The professional fee for reading a CT study was higher than for reading a radiograph, an uncontroversial policy. But estimating the technical fee for using CT (and later MR) raised problems that would persist for at least 30 years. Consistently generous technical fees created potential incentives to create and fill advanced imaging capacity and contributed to the emerging problem of health care inflation.

    • How Radiologists Are Paid: An Economic History, Part III: The Bubble Years
      Levy, Frank; Rosen, Max P. (2020-03-17)
      With the collapse of the Clinton health care reforms, advanced imaging entered an economic bubble. Between 1995 and 2006, the number of CT and MRI studies almost tripled, from 21 million to 62 million and from 9.1 to 26.6 million, respectively. The increase reflected increases in both the number of scanners and the number of scans generated per CT or MRI scanner. Without restrictions, the profits generated by CT and MR ownership inevitably spread from hospitals first to imaging centers and later to individual physicians' offices and led to potential for conflict of interest and self-referral. During this time, the increase in radiologists' efficiency was fueled by the conversion from "film" to digitized images and PACS. In conjunction with increased volume and efficiency, radiologists' compensation increased throughout the 1990s.

    • How Radiologists Are Paid: An Economic History, Part IV: End of the Bubble
      Levy, Frank; Rosen, Max P. (2020-03-24)
      During the first decade of the 21st century, the imaging bubble began to burst. The combination of digitized images, the DICOM standard, and affordable PACS sharply increased radiologists' productivity but also allowed an imaging study to be read from anywhere, creating the field of teleradiology and increased competition for radiologists. Increasing numbers of insurers contracted with radiology benefits managers to help control radiology utilization, and the Deficit Reduction Act of 2005 mandated spending cuts across the government. Consolidation of multiple Current Procedural Terminology codes and the reassessment of calculations used to estimate the utilization of a CT or an MRI scanner exerted additional downward pressure on radiology reimbursements. All of these factors, combined with more radiologists' completing residency and the delayed retirement of older radiologists after the 2008 financial crisis, brought the imaging bubble to an end.