Remote Arbitrage in Radiology: Multiple Affiliations as a Specialty Specific Adaptation to Changing Practice Demands

Area of Science:

• Health Services Research
• Medical Economics
• Physician Workforce Studies

Background:

• Physician affiliations with multiple groups and states can influence healthcare access and service delivery.
• Understanding trends in these affiliations is crucial for healthcare policy and planning.

Purpose of the Study:

• To analyze trends in group and state affiliations among Medicare-serving physicians from 2017 to 2024.
• To specifically examine these trends within diagnostic radiology compared to other specialties.

Main Methods:

• Analysis of Medicare Physician and Other Supplier Public Use File (2017-2024).
• Comparison of group and state affiliations between diagnostic radiologists and nonradiologist physicians.
• Statistical analysis including compound annual growth rates, t-tests, and regression models.

Main Results:

• Diagnostic radiologists exhibit significantly higher average group (2.03) and state (1.31) affiliations than nonradiologists.
• Diagnostic radiology saw positive compound annual growth rates in affiliations (+2.23% for groups, +1.63% for states) from 2017-2024.
• Other physicians showed minimal growth or decline in affiliations during the same period.

Conclusions:

• Diagnostic radiologists actively expand service reach via multiple affiliations, outpacing other physician groups.
• The adoption of multi-state and multi-group affiliations by other physicians remains limited despite potential for increased care access.