Aug 12, 2026
Curious about the future of radiology economics? Richard E. Heller III, MD, MBA speaks with co-hosts Sherry S. Wang, MBBS, and Surbhi Raichandani, MD, to discuss radiology economics, from the basics to the niche and what is up ahead. Listen to their discussion in episode 2 of Difficult Conversations, an AJR Podcast Series.
Full article: https://www.ajronline.org/doi/10.2214/AJR.26.35690
*Key Takeaways
The Efficiency Fallacy: CMS recently implemented a 2.5% efficiency reduction to work relative value units, assuming that technology makes reading scans faster. However, modern multiplanar CTs contain thousands of images which can slow down down interpretation times.
The No Surprises Act and Ghost Rates: While designed to protect patients from unexpected out-of-network bills, poor implementation allows insurers to use "ghost rates," which are contracted rates for never-billed services, to artificially lower the Qualifying Payment Amount and force rate reductions on practices.
Advocacy is Essential: Radiologists serve as the nexus of the hospital. If the specialty does not demonstrate its downstream value, such as avoiding unnecessary surgeries and shortening hospital stays, business-minded policymakers will continue to treat it as a high-cost expense center to be cut.
*Chapters
0:00 - Welcome
1:12 - Future Outlook For Radiology
2:27 - How Radiologists Generate Revenue
3:09 - RVUs Conversion Factor Basics
4:30 - MIPS And Payment Adjustments
5:59 - Revenue Versus Paycheck
7:22 - Medicare Fee Schedule Trends
8:53 - Efficiency Adjustment Debate
12:50 - How CMS Sets The Rules
14:24 - Comment Letters And Advocacy
17:16 - Medicare As System Benchmark
19:09 - Commercial Insurer Headaches
21:21 - Steerage And Pediatric Risks
22:57 - No Surprises Act Explained
27:59 - Arbitration And Implementation Issues
29:10 - Radiology as Nexus
30:16 - Proving Downstream Value
31:34 - Total Value Equation
33:44 - RVUs and Complexity
36:53 - Fixing Incentives
46:04 - AI as Capacity Booster
49:01 - Will AI Cut Pay
50:12 - Teleradiology Done Right
54:30 - Radiology in 10 Years
57:53 - Optimism and Call to Action
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*These sections were generated using artificial intelligence (Descript and Google Gemini) and then reviewed for accuracy.