The interventional radiologist (IR) has become a critical player in the care of patients with ever more complex diseases. From accurately assessing the nature, stage, and progression of disease, to delivering the right therapy at the right time, the IR sits at a critical intersection where the best diagnostic and therapeutic capabilities must converge. In this perspective piece, BCE looks at the shifting role of the IR, the nature of their practice, and the market forces that impact their business model.
System-driven cost pressures, increased need for diagnostic efficiency, enhanced demand for patient quality/satisfaction, and the push for lowered risk-reward ratios in medical procedures are all influencing the attention, opportunity, and growth that IR practices and physicians are experiencing. Historically, IRs within a large hospital setting focused mostly on traditional diagnostics and basic procedural responsibilities such as biopsies and fluid drainage, but had limited clinical responsibilities. Over time, as the efficacy of minimally invasive procedures to deliver drug therapy (e.g., ablation therapy in oncology; angioplasty or stenting in cardiology, thrombectomy in vascular disease) has improved, IRs have become increasingly responsible for clinical decision making and providing comprehensive longitudinal care to patients.
As these IRs expand into clinical care delivery and management, many are branching out to form their own independent IR clinics where they pursue greater control of patient outcomes and more favorable reimbursement dynamics. As such, they are learning how to engage with, seek referrals from, and be an integral part of care teams incentivized and accountable for value-based care aims throughout the patient journey. This means that the traditional diagnostics capability of the IR is now a means to an end – no longer a transactional, episodic event, but a critical pre-cursor for enabling therapeutic interventions across a continuum of care.
The IRs evolving practice model require other enabling capabilities and technologies. Some key ones include:
The dynamics of the interventional radiology market mirror those seen in the broader healthcare landscape today, namely the shift to outpatient and post-acute care settings, the push towards value-based care, and tightening reimbursement in the midst of technological innovation. Below we further explore these factors.
Evolution of the capital equipment model will be influenced by the dynamics between health systems, equipment manufacturers and independent IR clinics. Two competing trends influence these relationships – on one side, health systems are combatting a gradual erosion in IR procedure volume within their hospitals; on the other side, a growing number of independent facilities/IR clinics are capturing market share and expanding their practices. For manufacturers supporting these customers, it will be important to understand the capital equipment business model opportunities that could exist in either scenario.
For capital equipment manufacturers looking to serve the IR clinic, BCE believes it is important to assess the following questions:
1. What market-driven opportunities exist to pivot around the existing capital equipment business model directly and create novel streams of revenue via service, digital, or other approaches?
2. Are there opportunities for manufacturers to strategically support the implementation of new IR clinics in an effort to expand the market for, and use of IR capital equipment?
3. Are there opportunities for manufacturers to sponsor comparative effectiveness data studies with IR clinics that could help drive adoption of capital equipment?
4. What types of partnerships with IR-specific therapeutic companies could manufacturers explore to establish the value of IR guidance/ imaging tools alongside therapeutic offerings?
5. What value-based metrics can be captured from IR capital equipment and tools that would assist IRs in demonstrating the value of their integrated practices?
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