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300 255 250 170 Yes 150 139 101 100 29 to 30 in practices with less than 35. Big increases in practice size are an indication that mergers and acquisi- tions have been instrumental in send- ing the median practice size upward. We counted eight practices that grew by 10 or more FTE radiologists in the past year compared to just one such growth spurt in 2014. In the past year, the following prac- tices grew by 10 or more FTE radiolo- gists: University Radiology (10), Texas Radiology Associates, Plano, Texas (12), Columbus Radiology Corpora- tion, Columbus, Ohio (32), Radiology Associates of Florida, Tampa, Fla. (11), Northside Radiology Associates, Atlanta (17), Renaissance Medical Imaging Associates, Northridge, Calif. (23), Med- ical Diagnostic Imaging Group, Phoenix (11), and Advanced Medical Imaging Consultants, Fort Collins, Colo. Provider mergers are a likely factor in 50 63 2015 2014 2013 2012 2015 2014 2015 2014 2013 2012 28 2015 16 2014 44 ‘13 Figure 3. Groups reporting that they use a managed services organization (MSO). 2012 50 62 60 47 2013 58.8 % 2012 41.2 % 210 197 198 200 No 253 0 Figure 4. Median full-time equivalent (FTE) employees 2012–2015. the heightened merger and acquisition activity among private radiology prac- tices as they seek to provide a single level of service across increasingly sprawl- ing enterprises. Many health systems are seeking standardized service levels to meet system-wide quality metrics, another likely driver of merger activity. The largest and most ground- breaking transaction occurred when Columbus Radiology picked up six new hospital contracts and brought on most of the incumbent radiolo- gists. The practice added 32 radiol- ogists, catapulting from 47 radiolo- gists to 79 FTE radiologists, climbing from No. 72 to No. 13 on the Radiol- ogy 100 list. Another practice on the move is Renaissance Medical Imaging, which jumped from the 69th to the 36th largest practice in the U.S., adding 23 radiologists for a total of 56 since our count last year. The practice covers a wide swath of the San Fernando Val- ley as well as hospitals in Los Ange- les, San Bernardino, Inyo, Kern and Orange Counties. According to its web site, RIMA added at least five hos- pital contracts over the past year. Northside Radiology Associates rounds out the trio that added the most FTE radiologists. The group jumped from 54th to 31st on the list, adding 17 FTE radiologists for a total of 50. The group serves three hospi- tals and employs 18 FTE employees. Trends and anomalies On the surface, it appears that practices are exiting the imaging center business in droves. The median number of imag- ing centers owned declined in every practice cohort (Figure 2, page 20). Imaging-center ownership dropped precipitously in the largest practice-size | October/November 2015 | Radiology Business Journal 21