Is Radiology an Ancillary Service?

By many in healthcare, radiology is considered an ancillary service such as laboratory testing, drug dispensing, and physical therapy. Medicare and private insurance companies view radiology as an ancillary service.

In fact, Blue Cross Blue Shield (BCBS) of New Jersey  has attempted to

with radiologists. Rather than contracting with individual radiologists they now want to contract with radiology centers.

 This leaves radiologists vulnerable as they can be often bypassed by insurance companies who have the opportunity to contract with non-radiologist owned centers who possibly have teleradiologists. The insurance companies benefit from this by only dealing with the radiology facility rather than the individual radiologists. 

The big issue with this is that the insurance companies, in particular BCBS, are not valuing the individual radiologist and his or her education, board certification, and expertise. Insurance companies will have an easier opportunity to negotiate with non-radiologist-owned facilities and possibility leave radiologists practicing in the region out of the network. 

 I personally agree with BCBS that radiology is an ancillary service. However, I don’t agree that a service provided by a radiologist is an ancillary service. Radiologists play an active role in the management of patients well being. In contrast to laboratory results which do not have a direct input from a physician and instead is generated by a machine, every radiology study has a direct input from a physician which affects the outcome. 

I feel that as specialty physicians, radiologists need to correct this misinterpretation by Medicare and private insurance companies. By being categorized as an ancillary service, we are perpetuating the notion that radiology is a commodity. As our field is facing a commoditization problem, we must continue to address this issue and demonstrate value in our reports and make a distinction on our services.

Some of our value is in obtaining the best possible images for each study, but the majority of our value is our ability to dissect the images and make a diagnosis that will help the care of our patients and to effectively communicate it to the referring doctors and in some instances the patients.

This ties into the notion that the radiology field should try and separate the actual production of images from our analysis of the images as stated in a prior post.