The Service Line

Radiology Partners just closed the loop on an international ambition that collapsed a year ago, agreeing to buy Everlight Radiology and build the first true global teleradiology network out of the country’s largest private-equity-backed radiology group. Radiology Partners, Inc. announced August 25, 2026 that it signed a definitive agreement to acquire Everlight Radiology, a teleradiology provider covering the United Kingdom, Ireland, Australia, New Zealand and South Africa; Radiology Partners disclosed no price, though the Australian Financial Review reported a deal value of roughly 1 billion dollars, citing people familiar with the transaction. The combination folds Everlight’s international radiologist network into RP Clinical Services’ vRad unit, already the largest teleradiology platform in the United States, building round-the-clock, cross-border overnight and weekend coverage that independent US groups increasingly buy rather than staff themselves. It is Radiology Partners’ second attempt at global scale in eighteen months: this newsletter reported in July that the company’s earlier reported interest in Australia’s I-MED Radiology Network did not result in a deal, with private equity firm Permira instead selling I-MED to Hong Kong’s Jardine Matheson for about 2.4 billion dollars. For an independent group weighing whether to sell now or wait, a strategic buyer this large adding overnight, cross-border teleradiology capacity is one more sign that the coverage gaps independent practices already feel are exactly what today’s largest platforms are built to solve, and it raises the stakes on teleradiology’s oldest enforcement exposure, since federal rules generally will not pay for a final interpretation performed by a radiologist working outside the United States, the “ghost read” pattern that has produced multi-million-dollar False Claims Act settlements before. Confidence: High on the agreement and its structure, drawn from Radiology Partners’ own release; Medium on the roughly 1 billion dollar valuation, which traces to anonymously sourced reporting rather than a disclosed price. Sources: Radiology Partners to Acquire Everlight Radiology, Creating a Global Leader in Teleradiology, Radiology Partners, Radiology Partners to acquire Everlight Radiology in $1 billion deal, AuntMinnie, Everlight Radiology joins Radiology Partners, Everlight Radiology.

Reimbursement

Medicare’s proposed 2027 doctor pay rule keeps radiology’s biggest line item fight open for six more days, and this time the Centers for Medicare and Medicaid Services (CMS) is asking practices directly how deep to cut facility based imaging payments. CMS will close the comment period on the Calendar Year (CY) 2027 Medicare Physician Fee Schedule (MPFS) proposed rule on September 14, 2026, ahead of a final rule expected in early November. Beyond the conversion factor cut and the subspecialty level code swings this newsletter reported when the rule was proposed in July, CMS is asking directly whether it should keep, shrink, or eliminate the policy that cuts the indirect practice expense payment allocated to facility based services by 50 percent, a reduction CMS first adopted for 2026 and proposes to hold at 50 percent for 2027 while explicitly soliciting comment on whether the number should be lower, potentially zero. Because most hospital based and outpatient department radiology billing runs through that facility based indirect practice expense formula, the size of this one percentage is now the practical fight, not the headline conversion factor number practices quote to hospital administrators during subsidy negotiations. Confidence: High on the comment deadline and the specific practice expense methodology question, corroborated across CMS’s own fact sheet and independent legal and consulting summaries of the proposed rule text; Medium on how CMS is likely to rule, since no indication of the agency’s leaning was found this run. Sources: Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule, Centers for Medicare and Medicaid Services, CMS Issues CY 2027 Medicare Physician Fee Schedule Proposed Rule, Holland & Knight.

Enforcement

A government radiology department collapsed inside six months this year, and the Department of Veterans Affairs’ own watchdog just confirmed why. The Department of Veterans Affairs Office of Inspector General (VA OIG) reported August 5, 2026 that four of the five full time radiologists at the VA Washington D.C. Healthcare System, including the chief of radiology, resigned between July and December 2025 after the facility’s return to office policy took effect, producing what investigators called a mass exodus and delays in reading backlogged imaging studies. The OIG found facility leaders did not follow required protocols for notifying quality management once the backlog and delays emerged, and as of February 2026 the OIG’s related December 2025 recommendation that Veterans Health Administration leadership build a sustainable radiology staffing plan remained open and unresolved. For operators anywhere in the shortage market, government owned or not, the episode is a clean case study in how fast a coverage model breaks once even a handful of subspecialists leave a facility with no bench, and how visible that failure becomes once an inspector general writes it down. Confidence: High, drawn from the VA OIG’s own published findings and confirmed independently by contemporaneous trade reporting. Sources: Healthcare Facility Inspection of the VA Washington DC Healthcare System, Department of Veterans Affairs Office of Inspector General, VA Inspector General Confirms Prospect Reporting on Radiologist Shortage, The American Prospect, VA Radiologist Exodus ‘Tip of Iceberg’, The Imaging Wire.

Who’s Buying

An 8 billion dollar radiopharmaceutical merger just answered the supply chain question sitting underneath radiology’s fastest growing revenue line. Curium and Lantheus Holdings announced August 3, 2026 a definitive agreement under which Curium US Holdings will acquire all outstanding Lantheus shares for 102.50 dollars per share in cash, plus contingent value rights worth up to 12.00 dollars more per share tied to commercial milestones, a transaction valued at up to 8.0 billion dollars and a 38 percent premium to Lantheus’ unaffected 60 day trading average. The combined company would span radiopharmaceutical diagnostics and therapeutics, including the manufacturing and distribution infrastructure behind positron emission tomography (PET) tracers and targeted radioligand therapies, serving patients in more than 70 countries. For imaging operators building out theranostics and PET service lines, the deal consolidates two of the sector’s larger dose suppliers at the exact moment isotope supply, not scanner capacity or reimbursement, is the binding constraint on how fast that growth line can scale. Confidence: High, drawn directly from the companies’ own joint release and SEC filing. Sources: Curium Announces Definitive Agreement to Merge with Lantheus, Curium Pharma, Curium Announces Definitive Agreement to Merge with Lantheus, Lantheus Holdings Investor Relations, Lantheus Holdings, Inc. Form 8-K, U.S. Securities and Exchange Commission.

Clinical Policy

Breast imaging’s biggest screening fight is still unresolved, and it is a fight over how often, not just when, to scan. The American College of Physicians (ACP) published a revised breast cancer screening guidance statement in Annals of Internal Medicine on April 17, 2026, recommending biennial rather than annual mammography for average risk women ages 50 to 74, and shared decision making rather than routine annual screening for women ages 40 to 49. The American College of Radiology (ACR) and Society of Breast Imaging (SBI) responded that the guidance relies on outdated evidence and, if adopted, could contribute to up to 10,000 additional breast cancer deaths a year, citing regularly screened women’s roughly 47 percent lower risk of breast cancer death within 20 years and noting that ACP does not address supplemental screening for women with dense breast tissue beyond tomosynthesis. Neither the U.S. Preventive Services Task Force (USPSTF) nor most major cancer organizations have moved toward ACP’s position since April, so the guidance remains a minority view, but a breast imaging service line still has to decide today which interval and age range to build its patient recall and staffing model around while professional societies openly disagree. Confidence: High on both organizations’ published positions; Medium on real world adoption, since no payer or health system was found this run to have shifted coverage or scheduling policy toward the ACP guidance. Sources: Screening for Breast Cancer in Asymptomatic, Average-Risk Adult Females, American College of Physicians via Annals of Internal Medicine, New guidance from ACP says all average-risk females aged 50-74 should undergo biennial mammography screening for breast cancer, American College of Physicians, New ACP Breast Cancer Screening Guidelines May Cost Lives, American College of Radiology.

The Operator Metric

The number to track this week: 10.8 percent, the year over year pay increase for interventional radiologists, the largest raise of any physician specialty in the country. Doximity’s 2026 Physician Compensation Report, released August 25, 2026 from nearly 23,000 physician surveys completed in 2025, found interventional radiology posted the largest year over year compensation gain of any physician specialty at 10.8 percent, to an average of 634,658 dollars, while diagnostic radiology rose 6.6 percent to 609,684 dollars, enough to make radiology the only specialty to place in the top ten for compensation growth in both 2024 and 2025. Overall physician compensation rose just 2 percent over the same period, the slowest pace in years, meaning radiology’s raise is running several times the physician wide average even as reimbursement per study keeps falling, a gap operators are funding through hospital subsidies and heavier per radiologist workloads. For a group modeling next year’s hospital coverage contract or recruiting budget, this is the current market clearing price, and interventional radiology specifically is now commanding the steepest premium in the country. Confidence: High, drawn directly from Doximity’s own published report. Sources: Doximity 2026 Physician Compensation Report, Doximity, Interventional radiology tops compensation growth in 2025, AuntMinnie.