Interventional radiologists (IRs) who focus the majority of their workload on image-guided procedures are more likely to perform complex interventions and deliver more in-person clinical care, according to a national Medicare study published in the Journal of the American College of Radiology.

The analysis, led by the Harvey L. Neiman Health Policy Institute in collaboration with IR experts, evaluated claims data from over 30,000 U.S. radiologists. It found that those with the highest concentration of IR work, defined as more than 90% of their services, performed procedures with twice the average work-relative value units (wRVUs) compared to peers with minimal IR involvement. Additionally, this high-IR group conducted three times as many evaluation and management (E&M) visits per procedure.

“Compared to radiologists who spend in the range of 30-50% of their work providing IR services, those with 90% or more IR focus performed about 3 times as many E&M visits per procedure,” said Eric Christensen, Ph.D., research director at the Neiman Institute and lead author of the study. “Our results show that clinical visits and procedural practice are interdependent. Protecting IR office hours time in radiology practices is essential for delivering more complex, higher-value procedural care.”
Only a small subset of radiologists met the threshold for high IR involvement. In 2022, just 1,366 IRs nationwide devoted more than 90% of their work to interventions. When the bar was lowered to over 50%, the number rose to 2,859.

Researchers also observed a shift in how non-physician practitioners (NPPs) are used in different practice settings. In diagnostic-heavy groups, NPPs primarily performed procedures. In contrast, in practices with more IR focus, NPPs handled the majority of E&M services.

Study authors suggested that preserving physician office hours and strategically using NPPs could help practices support higher-value, longitudinal IR care in the face of rising diagnostic imaging demands.

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