In the Heights: The Radiology 100 Achieves a New High, Steady Growth Prevails

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GettyImages-513132951-rad100-2016.jpg - Radiology 100, 2016

It was grow or forfeit ground, when it came to retaining rank on the list of the nation’s largest radiology practices this year. To judge from the change—or more precisely decline from 47 to 43—in the median practice size of the country’s largest 100 radiology practices, one might be tempted to assume that radiology put practice-size growth on hold in 2015.

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Scratch the surface, however, and it is clear that radiology practices have continued to grow, particularly at the top of the ranking. For instance, the average size grew from 52 in 2015 to 53.5 in 2016. More tellingly, we ranked 26 practices with more than 65 radiologists compared to 20 in 2015. In 2009, when we began ranking the 50 largest private radiology practices, there were eight.

More than 130 practices submitted full or partial data to be ranked among the 100 largest private radiology practices in the United States, cosponsored by Radiology Business Journal and CliftonLarsonAllen, Minneapolis, Minn. Data for an additional 61 radiology practices of known size were solicited through phone calls or gathered from web sites. When a practice’s number of FTE radiologists was counted on a web site, the total number was reduced by 5% to account for the presumed difference between FTE numbers and radiologist total head count.

The survey for the ninth annual ranking of the nation’s largest private radiology practices was posted online at and emailed to our distribution list. Practices were ranked based on their number of FTE radiologists and where there was more the one practice of the same size, the number of FTE employees was considered.

As in past years, we also collected the number of procedures performed, the number of hospital contracts and the number of imaging centers owned, as well as whether the practice operates a managed-services organization (MSO). This year we also asked practices to share the number of work relative value units (wRVUs) per radiologist, average shift length and number of shifts worked per year, in addition to annual revenue, although we do not share financial numbers with readers. We also asked participants to specify the type of MSOs they operated.

Only private radiology practices were ranked. We defined private practices as wholly owned by physician shareholders, with no outside investment from private equity or other sources. We also did not include employed practices, which excludes many large academic practices.

Top five

You will not encounter any new practices at the very top of the list: The same five mega-practices ranked in the same exact order as in the 2015 ranking. Although the players and their rankings remained the same, their achievement was not earned through the status quo. All five of the top-ranking practices added radiologists last year.

The nation’s largest practice also registered the greatest growth. Last year, Radiology Associates of North Texas (RANT), Fort Worth, topped the list with 128 FTE radiologists; this year it added 36 radiologists for a total of 164 FTE radiologists.

In March, RANT reported that two groups would join the practice, Texas Neuroradiology, with five radiologists, and Radiological Consultants Association, which brought 31 radiologists into the fold. The practice also added eight hospital clients since 2015.

Claiming the number two spot on the list two years running, University Radiology, New Brunswick, NJ, weighed in with 119 FTE radiologists, compared to 106 in 2015, registering the second largest growth spurt on record this year. In January, the practice merged with Associated Radiologists, a 19-radiologist practice based in Bridgewater, NJ.

University Radiology serves 13 hospitals and has an ownership interest in 20 imaging centers, providing employment to 650 FTE employees. The practice provided interpretations for 1,860,000 procedures in 2015.

In third position, Advanced Radiology Services, Grand Rapids, Mich., added two FTE radiologists for a total of 108 FTE radiologists. Advanced Radiology Services has been among the largest five practices in the nation since we began ranking practices of size in 2009. It added two hospital clients for a total of 17.

Advanced Radiology Services was at the top of the list with 106 FTE radiologists in 2009. Two of the four other original top-five practices have continued to grow, but not fast enough to remain in the top five; one of the four was acquired by its primary client; and the other lost more than