Friday, June 15, 2012

Radiology Salary: Cautious Optimism?

The American Medical Group Association (AMGA) recently released their 24th annual survey of physician groups. The Annual Medical Group Compensation and Financial Survey was a mixed bag of results. Almost 70% of groups noted an increase in compensation, but the increase was quite small on average: 2.4%.

The question I bet you're wondering though: how did radiology salaries do? All told, not bad, but not spectacular either. The top five specialties were: cardiothoracic surgery ($532,567), interventional cardiology ($504,099), orthopedic surgery ($501,808), interventional radiology ($492,102), and diagnostic radiology ($354,917). However, of the five, interventional radiology had the second highest growth of 2.95%, just behind the interventional cardiologists' 4.13%. The cardiothoracic surgeons actually experienced a decline!

The main figure to watch though is the relative value unit, or RVU. An RVU is the primary measure of a physician's productivity for the majority of participating medical groups. Medicare decides that each procedure is worth a certain number of RVUs. That value is then adjusted by the geographic location / practice environment of the physician. The adjusted RVU is then multiplied by the a dollar conversion factor to arrive at the amount Medicare will re-imburse. Most HMOs in the U.S. use this value as a basis for their repayments. Many physician groups charge up to 300% of this value, and then recoup 60-80% of that amount. For example, take a procedure generally worth one RVU. In Manhattan, this might be adjusted to 2 RVUs. At a conversion factor of $50, Medicare would reimburse $100 for this procedure. The physician group may charge up to $300 to a private insurance company, and could expect to collect roughly $180 to $240 on average.

In radiology, RVUs have been falling, so radiologists have had to work harder (complete more RVUs) to maintain the same salary level. This trend is likely to continue, regardless of whether the Affordable Care Act ("Obamacare") passes in full or in part. Healthcare reform of some shape or another will occur. Radiologists will likely face even further decreases in compensation. The real question is: how will radiologists respond? No one is quite sure yet, other than there will certainly be change.

But going back to the title of the post - what cause is there for optimism about radiology salaries? Well, whatever optimism is there, it is indeed a cautious one. Looking further back in the data, salaries tend to stay flat for a few years, then advance, then flatten again, in a step-wise fashion. Radiology salaries have been fairly flat since 2008, so the field is due for a step up. Whether that happens in 2013 or 2015 though, is anyone's guess. Any future gains are contingent on the broader economy advancing. Til then, keep knocking out those RVUs!

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