Radiology Payments Fell 9.4%

While professional claims payments saw a significant drop, facility claims for in-network diagnostic radiology fell by a much smaller 2.2% over the same five-year period. The Government Accountability Office's analysis covered approximately 153 million claims, with 57% being professional and 43% facility-based. Notably, the in-network rate for radiology services remained consistently high, around 99%, both before and after the No Surprises Act took effect. This reimbursement pressure coincides with a major site-of-care shift, as payers increasingly direct non-emergency imaging to outpatient settings to curb costs. Some studies suggest that up to 25% of hospital-based radiology services could be moved to outpatient centers, potentially saving the healthcare system billions. In response, many health systems are aggressively expanding their freestanding imaging footprint through acquisitions, joint ventures, or building new facilities. The outpatient imaging market is experiencing intense consolidation, with private equity firms, hospitals, and large imaging networks like RadNet and SimonMed pursuing aggressive acquisition strategies. This trend is making imaging IT contracts larger and longer, creating a more challenging environment for new vendors to enter the market. The U.S. outpatient imaging IT market currently represents 47% of total radiology IT spending and is projected to exceed 50% by 2028. Key players in the mobile imaging services market, which is forecast to reach $24.9 billion by 2032, include RadNet, Inc., Alliance HealthCare Services, and MedQuest Associates. These companies are expanding their reach into diverse care settings like ambulatory centers and home healthcare to meet the growing demand for decentralized diagnostics. The mobile MRI market alone is expected to grow to $4.86 billion by 2034, driven by the need for accessible imaging in rural and high-volume areas. This shift is happening as radiology practices themselves are consolidating. Between 2014 and 2023, the number of radiologists in radiology-only practices decreased from 49.7% to 37.0%, while those in multispecialty practices grew from 50.3% to 63.0%. During the same period, the number of practices with 100 or more radiologists grew by nearly 350%. To manage rising imaging volumes and staffing shortages, providers are increasingly turning to technology. The FDA has seen a surge in approvals for AI-enabled medical devices, with radiology being the dominant specialty, accounting for about 77% of such approvals. As of mid-2025, the FDA had approved 873 AI algorithms specifically for radiology, with companies like GE HealthCare, Philips, and Fujifilm leading the way.