SIR 2024
General IR
Trang Truong (he/him/his)
Student
Warren Alpert Medical School of Brown University
Financial relationships: Full list of relationships is listed on the CME information page.
Mihir Khunte, BS
Medical Student
Yale University School of Medicine
Disclosure information not submitted.
Dheeraj Gandhi, MD
Professor of Diagnostic Radiology and Nuclear Medicine
University of Maryland School of Medicine
Disclosure information not submitted.
Aaron W. Maxwell, MD
Professor
Alpert Medical School, Brown University
Disclosure information not submitted.
Interventional radiologists (IRs) have faced increasing pressures to control costs and demonstrate quality of care improvements due to changes in payment models from governments and private payers {1}. These payment reforms, coupled with private equity and hospital system acquisitions, have been challenging for small physician practices to navigate and may be prompting IRs to join larger practice groups {2}. To detect such trends, this study examines changes in IRs’ practice sizes within the past 10 years, as well as differences between urban and rural settings.
Materials and Methods:
Using the CMS Physician Compare database, a retrospective analysis of the size of practices with IRs from 2013-2022 was performed. IRs were identified and categorized as working in rural or urban settings using the 2010 U.S. RUCA codes, with our primary outcome being the change in the number and proportion of IRs working in practices of various sizes (1, 2-4, 5-10, 11-24, 25-49, and 50+ clinicians) within each setting. Statistical significance of changes was assessed using the Mann-Kendall test. Hochberg-Bonferroni adjusted P-values< 0.05 were determined to be statistically significant. A total of 36,983 IRs were included in the analysis from 2013 to 2022. Between 2013 and 2022, the total counts of IRs working in smaller practices (solo, 2-4 clinicians) and larger practices (25-49, 50+ clinicians) all increased. However, only the proportion of IRs working in the largest practice size category increased while the proportion of IRs working in all other practice size categories decreased. From 2013 to 2022, the proportion of IRs working in practices with 50+ clinicians increased from 53.78% to 72.42% (adjusted p=0.0027), while the proportion of IRs working in solo practices decreased from 3.65% to 2.53%. Similarly, the proportion of IRs working in mid-sized practices with 5-10 and 11-25 clinicians decreased from 9.05% and 15.75% to 3.86% and 7.90%, respectively (adjusted p=0.0027). Additionally, changes in the proportion of IRs working in each practice size category were greater in magnitude for rural settings compared to urban ones. Between 2013 and 2022, the proportion of IRs working in larger practices increased while the proportion of IRs working in smaller practices decreased, potentially signaling a shift towards consolidation as more IRs practice in larger systems. Notably, this process may disproportionately affect rural settings. These findings raise important questions about the future accessibility of services as the IR workforce trends towards larger urban settings.
Results:
Conclusion: