Study: Radiology Practices in Distress Because of COVID-19 Pandemic

A team of medical researchers has produced an article in the Journal of the American College of Radiology (JACR) online, whose conclusions, based on a survey of American College of Radiology (ACR) member organizations, has found that radiology practices nationwide have been negatively impacted by the COVID-19 pandemic, with nearly 70 percent of all radiology practices having applied so far for financial relief.

Officials from the ACR and from the Radiology Business Management Association (RBMA) published the article on August 4, based on the results of a survey of more than 200 radiology practices nationwide, with the survey having been conducted online by the ACR and RBMA during May 2020.

The article, entitled “COVID-19 Initial Impact on Radiology Practices: Survey from ACR/RBMA,” was written by Ajay Malhotra, M.D., Xiao Wu, M.D., Howard B. Fleishon, M.D., Richard Duszak, Jr., M.D., Ezequiel Silva III, M.D., Geraldine McGinty, M.D., Claire Bender, M.D., Beth Williams, M.H.A., Neale Pashley, Casey J.B. Stengel, M.P.A., Jason J. Naidich, M.D., Danny Hughes,, Ph.D., and Pina Sandelli, M.D., M.P.H.

The authors report that, “During April 2020, nearly all radiology practices reported substantial (56.4-63.7 percent) declines in imaging volumes with outpatient imaging volumes most severely affected. Mean gross charges declined 50.1-54.8 percent and collections declined 46.4-53.9 percent. Percentage of reductions did not correlate with practice size. Majority of respondents believed that volumes would recover but not entirely (62-88 percent) and anticipated a short-term recovery, with a surge likely in the short-term due to postponement of elective imaging (52-64 percent). 15.6 percent reported that radiologists in their practices tested positive for COVID. Over half (52.3 percent) reported availability of personal protective equipment had become an issue or was inadequate. A majority (62.3 percent) reported that their practices had existing remote reading or teleradiology capabilities in place prior to the pandemic, and 22.3 percent developed such capabilities in response to the pandemic.” They conclude that “Radiology practices across different settings experienced substantial declines in imaging volumes and collections during the initial wave of the COVID-19 pandemic in April 2020. Most are actively engaged in both short- and long-term operational adjustments.”

Key statistical findings included the following:

> Survey results revealed a reported 56.4-63.7 percent decline in the overall imaging volumes across the spectrum of practice settings for the month of April 2020.

> The reported decline in imaging volumes was greatest in the outpatient setting, however almost 40 percent decline was reported in the ED and inpatient settings during the initial wave.

> Significant declines in receipts and gross charges were reported by almost all practices and nearly 70 percent of respondents indicated that they had applied for financial relief programs.

Distressingly, the report finds that, during April, “There was a drop of nearly 90 percent in elective procedures across practices, with a decrease of urgent procedures reported by 62.7 percent of hospital-based practices and 67.2 percent by mixed practices. For interventional radiology and other invasive procedures, many practices made changes to scheduling. 19.3 percent reported that their interventional radiology practices were assigning alternating weekly or bi-weekly schedules; 3.5 percent reported redeployments to other hospital COVID-related services (i.e. screening sites, emergency or inpatient care), 2.6 percent reported redeployments to other hospital COVID-related services (i.e. screening sites, emergency or inpatient care), but 43 percent reported regular scheduling in place.” All of this led to severe financial impacts, including a mean reduction in receipts of 53.9 percent for imaging centers, and 47.3 percent for hospital-based organizations.

The ACR and RBMA have not surveyed radiology practices in the past couple of months, but some rebound seems to have occurred in terms of radiology service volumes; evidence of that comes from a report in the publication Radiology Business. In a July 30 article, Radiology Business’s Marty Stempniak reported on the fluctuating financial situation of the Sunrise, Fla.-based Mednax, which encompasses the teleradiology company VRad. Stempniak reported in that article that “Industry giant Mednax recorded a 29 percent drop in its radiology service volumes during the second quarter that ended June 30, but numbers appear to be rebounding. The decline in business was worse in April at 50 percent, but levels reached upward of 90% of pre-COVID volume by the end of June, the Florida physician firm reported Thursday. Mednax just hired a new CEO earlier this month, who this week affirmed plans to unload the company’s imaging business line to focus on its core businesses in pediatrics and obstetrics.” Still, he noted, “Mednax said same-unit revenue from net reimbursement-related factors increased by 0.2 percent in the second quarter, and the firm collected $11.7 million in aid as part of the CARES Act. However, those positives were partially offset as net pricing for services delivered by some of its radiology groups were tugged downward by reductions in administrative fees tied to imaging volumes.”

Stempniak added that, “All told, Mednax reported a net loss of more than $672 million, or $8 per share, during the second quarter on revenue of $509 million, with same-unit sales sliding 11.7 percent. Adjusting earnings to before interest, taxes, depreciation and amortization, Mednax netted $65 million during Q2.”