How Radiologists Are Paid: An Economic History, Part IV: End of the Bubble

During the first decade of the 21st century, the imaging bubble began to burst. The combination of digitized images, the DICOM standard, and affordable PACS sharply increased radiologists' productivity but also allowed an imaging study to be read from anywhere, creating the field of teleradiology and increased competition for radiologists. Increasing numbers of insurers contracted with radiology benefits managers to help control radiology utilization, and the Deficit Reduction Act of 2005 mandated spending cuts across the government. Consolidation of multiple Current Procedural Terminology codes and the reassessment of calculations used to estimate the utilization of a CT or an MRI scanner exerted additional downward pressure on radiology reimbursements. All of these factors, combined with more radiologists completing residency and the delayed retirement of older radiologists after the 2008 financial crisis, brought the imaging bubble to an end.