Selling or partnering your radiology practice in France: tariff cuts, investment funds and partner radiologists' choices

For a long time, a radiology practice was handed on between colleagues: a departing partner sold their shares to the remaining radiologists or to a co-opted young practitioner. This model still exists, but it competes with another logic. Over the past ten years, imaging groups, often backed by investment funds, have been acquiring practices, financing CT scanners and MRIs, pooling teams and tools, and offering radiologists the chance to stay in the capital while shedding management. At the same time, the national health insurance fund has made imaging one of its main savings targets.

French radiology still relies on many groups of independent doctors, and it remains far less concentrated than medical biology, where six groups hold three quarters of sites according to the IGF-IGAS mission on medical biology. This fragmentation, combined with the weight of equipment and operational complexity, still leaves plenty of room for regional and national combinations. For a partner radiologist, this changes the buyers, the timing and the preparation of their practice.

A market of nearly €4 billion, growing and under scrutiny

Community radiologists billed around €3.8 billion to the health insurance fund in 2024, €2.1 billion in procedures and €1.7 billion in technical fees, up around 22% since 2019 according to the joint report by the General Inspectorate of Finance (IGF) and the General Inspectorate of Social Affairs (IGAS) published in July 2025, for more than 77 million procedures a year. ¹ It is a prescribed, reimbursed and structurally growing activity, with cross-sectional imaging gradually overtaking conventional radiology.

Equipment has followed: 1,312 MRIs and 1,432 CT scanners were installed in January 2024, up 31% and 20% respectively in five years, and 63% of MRIs belong to the for-profit private sector or private practices. ¹ Technical fees, which pay for the machines, represent 34% of radiologists' fees against 29% in 2019. ¹ The same report measures EBITDA relative to revenue rising from 10% to 13% between 2018 and 2023, and notes sector concentration accompanied by rising private equity involvement. ^1,2 The profession has 9,140 radiologists, 58% exclusively in private practice, younger than the medical average: 9% are over 60, against 23% for all doctors. ¹ Yet radiology is not just a fleet of machines: a practice's value also lies in its medical capacity, its authorisations, the organisation of its sessions and its integration with local facilities and prescribers.

The drivers of consolidation

The restructuring of private imaging rests on mutually reinforcing factors.

Tariff pressure on technical fees. The 2025 social security financing act set a target of at least €300 million of imaging savings by 2027. ^3,4 A first wave of cuts, imposed in the absence of agreement, took place in October 2025, a second on 1 July 2026, half of them on technical fees. ^3,4 The IGF-IGAS report estimates these fees cover on average 163% of costs, which the radiologists' federation FNMR disputes, stressing that machines are renewed every five to seven years, not fourteen. ⁵ An isolated practice absorbs these cuts alone.
Capital intensity. A complete platform requires several million euros of equipment, renewed regularly, plus information systems, PACS and RIS, cybersecurity and AI diagnostic support tools, which require capital and planning capacity. The authorisation reform resulting from the September 2022 decrees makes it easier to add machines to an already authorised site, and regional health agencies are issuing many new authorisations: 345 in the Paris region in October 2025, including 188 additional pieces of equipment. ⁶ Seizing them requires equity partners cannot always provide.
Medical demographics and the radiographer shortage. The lack of radiographers limits the opening of examination slots, and 48% of hospital radiologist posts are vacant. ¹ In several territories, on-call duties and recruitment have become the main constraint. Groups offer career paths and shared rotas mid-sized practices struggle to match.
Network organisation and machine utilisation. A larger network optimises examination slots, distributes specialties between sites and improves utilisation of costly equipment. This industrial logic pushes towards building coherent regional groups rather than running an isolated site.
Teleradiology and young radiologists' expectations. Remote reading and the 17 shared imaging platforms identified in 2025 let a group cover several territories with centralised staff. ¹ Practitioners setting up also look for practice in a large group, specialised by organ, with gradual entry into the capital: for a small practice, recruiting a successor often means joining a larger structure, and each departure of a shareholding partner calls for a governance and financing solution.

Who buys practices today

The legal framework shapes the form of transactions without preventing them. Radiologists practising in the professional practice company (SEL) must hold a majority of the capital and voting rights, with third-party participation limited to 25% of the capital. ^7,8 Investors therefore act through service companies and holdings, debt, or preference shares that leave voting rights with practitioners and direct a large share of profits to the financiers. ^7,8 The Senate report on the financialisation of healthcare, adopted in September 2024, describes imaging as the sector where this dynamic is most active and proposes enshrining the notion of effective control in law. ⁷ Deregistrations ordered by the medical order have been overturned by the Conseil d'État and a large fund abandoned an acquisition in 2024 for regulatory reasons: each structure must be examined carefully and remain compatible with medical practice. ^8,9 Five buyer profiles stand out.

Fund-backed platforms. Around ten combinations have been carried out in three years according to Xerfi, around groups such as Simago, Résonance Imagerie or ImaOne. ⁸ Their logic is buy-and-build: build a network of practices, pool purchasing, IT and teleradiology, then sell the whole within five to seven years, with sellers often reinvesting part of the price in the holding.
Regional radiologist groups. Formed by successive mergers of practices in the same area, they look for geographic and medical complementarity and may in turn open up to a minority investor to finance their development.
Networks of independent radiologists. The Vidi network brings together 75 imaging groups, 1,200 radiologists and 400 sites, nearly a quarter of private radiology according to its October 2024 figures, in a model where practitioners intend to keep control of their working tool while pooling purchasing and services. ¹⁰
Clinic groups. Private hospital operators own imaging centres and seek to secure the radiology attached to their facilities.
Neighbouring colleagues and reorganisations between partners. Merging two or three practices in the same area remains the most natural combination to share a technical platform and organise succession, without an investor. Bringing in young radiologists or an internal share buy-back can also organise succession without a full sale.

What this changes for the partner radiologist

There is no longer a single succession model, but several.

A full sale suits partners close to retirement, with a period of one to three years practising to ensure continuity.
A partnership with reinvestment is for partners, whatever their age, who still have several years of activity ahead: they sell a majority of the shares, reinvest part of the price in the group's holding and share in the value created at the next transaction.
A combination between colleagues creates a territorial group controlled by radiologists, finances equipment jointly and attracts young partners.
A capital reorganisation such as an OBO lets the most senior partners monetise part of their shares, financed by debt, and bring young radiologists into the capital on sustainable terms.

Whatever the structure, a buyer's analysis is highly specific to the sector: it looks simultaneously at medical activity, operating rights, equipment and the practice's ability to retain its radiologists. Here are the criteria that come up in every file.

Authorisations and equipment. Type of equipment, age, authorisation expiry dates, expansion possibilities on existing sites, current financing and renewal schedule give the regulatory and industrial visibility on which the whole project depends.
Locations. Patient access, proximity to healthcare facilities, competitive density of the area and complementarity with the buyer's network determine each site's strategic value.
The medical team. Number of radiologists, age and specialty profile, on-call and session organisation, partnership policy and the collective ability to retain practitioners after the deal determine continuity of activity.
Activity mix and revenue. Share of heavy imaging, conventional radiology, breast imaging and interventional work, weight of technical fees in revenue and exposure to the next tariff cuts have distinct dynamics the buyer models.
Prescribers and agreements. Diversity of community prescribers, agreements with clinics and hospitals, site leases: a practice whose activity relies on a single facility is examined more cautiously.
Systems and organisation. Quality of the information system, appointment lead times, secretariat, billing, patient journey and radiographer stability directly influence performance and ease of integration.
Real profitability. Once partners' pay is normalised and recent investments adjusted, recurring margin, site by site, is the basis for discussion.

You are thinking of selling: is this the right moment for you?

This is the first question we ask, and the answer is not the same for everyone. The right moment for a sale or partnership is never automatically "right now", even in a market with many well-financed buyers. It depends on two things: you, meaning your life plans, personal horizon and wealth objectives, and your practice, meaning its ability to realise today all the value it holds. We encounter two situations.

Your practice is almost ready. Authorisations are secure, equipment is recent and financed, prescribers are diversified, the team is stable, partners are aligned on their plans and profitability is readable. Or you want your practice to become part of a larger project, that of a large group, often under LBO, that brings the tools, expertise and resources to absorb tariff cuts and machine renewal, which is reassuring for you and for your teams. In this case, a few weeks of preparation are enough to go to market. The current context, with more buyers than ever, then works in your favour.
Your practice needs time. An authorisation is expiring, a partner clinic accounts for too large a share of activity and is renegotiating its agreement, margin was hit by the recent purchase of an MRI or the first wave of tariff cuts, or partners do not yet agree on future governance. Selling remains possible, but it means accepting a discount and less favourable terms. We will then tell you frankly that it is better to spend several months, sometimes a few years, working on these points, and we can support you through that phase before launching the transaction when you are truly ready.

The workstreams that make the difference in imaging are well known: document activity by site and modality, secure and if possible extend authorisations, plan equipment renewal and its financing, diversify prescribers and formalise agreements with facilities, stabilise the radiographer team, normalise partners' pay, and prepare the legal side, notably agreements and any holding company. The arrival of young radiologists, an equipment renewal or opening a site are often natural moments to rethink the capital. Depending on your starting point, these workstreams take a few weeks or a few years.

The benefit of talking early, even without being sure you want to sell, is knowing which of these two situations you are in, and deciding with full knowledge rather than under the pressure of an approach, a partner's departure or a new tariff cut.

Facing platforms that complete several acquisitions a year with dedicated teams, a radiologist negotiating alone is rarely on an equal footing. The value of a practice is not just a headline price: it depends on the deal structure (cash portion, earn-out, reinvestment), the warranties, partners' practice and pay conditions, the future of the teams and the governance retained. Two offers for the same amount can mean very different things.

The role of an independent M&A adviser is to value the practice objectively, identify all relevant buyers, platforms, regional groups, radiologist networks, facility groups and colleagues, put them in competition in a structured and confidential process, and negotiate terms beyond price alone. This competition protects the seller: it lets them compare genuinely different projects and choose the one that suits them.

Frequently asked questions

Is radiology as concentrated as medical biology?

No. Medical biology is dominated by a handful of groups holding the vast majority of sites, whereas private imaging still relies on many independent practices and radiologist groups. Combinations are progressing fast, driven by investment funds and the cost of equipment, but the market still leaves plenty of room for regional and national combinations. That explains the high number of buyers today.

Can an investment fund buy a radiology practice in France?

Not directly as a majority owner. Radiologists practising in the professional practice company must hold a majority of the capital and voting rights, and third-party participation is limited to 25% of the capital. ⁸ Funds therefore act through holdings, service companies, debt or preference shares, structures the Senate and the medical order watch closely. Each deal must be examined to remain compatible with the independence of medical practice.

Why does a radiologist group partner with an investor?

To finance the renewal of MRIs and CT scanners and seize new authorisations, pool support functions, IT and teleradiology, improve recruitment of radiologists and radiographers, and absorb tariff cuts within a larger group. For partners, it is also an opportunity to monetise part of the value created while continuing to practise.

Can you sell your radiology practice and continue to practise?

Yes, buyers even expect it, as they need radiologists to ensure medical continuity and the relationship with prescribers. After a full sale, the partner generally practises for one to three years within the group; after a partnership with reinvestment, they continue long term and share in the value created at the next transaction. Practice conditions and pay are negotiated alongside the price.

Who buys medical imaging practices in France?

Fund-backed platforms such as Simago, Résonance Imagerie or ImaOne, regional radiologist groups formed by successive mergers, independent networks such as Vidi, clinic groups securing imaging for their facilities, and neighbouring colleagues combining to share a technical platform. Each brings a different plan for the practice and its partners.

How long does it take to sell or partner a radiology practice?

Generally six to twelve months between launching the process and signing: preparing the file, confidentially approaching buyers, offers, regulatory, financial and legal due diligence, negotiation, then formalities relating to authorisations and the medical order. Prior alignment of partners on the project is the main factor of speed; disagreement on future governance can slow the process considerably.

What are the main risks of a radiology deal?

Lack of alignment between partner radiologists, an expiring authorisation, equipment to renew without planned financing, excessive dependence on one facility or a few prescribers, and a legal structure incompatible with capital ownership rules. Serious preparation identifies these points before going to market rather than in the middle of due diligence.

Why put several buyers in competition to sell your radiology practice?

Because projects differ on much more than price: medical governance retained, partners' practice and pay conditions, share reinvested in the holding, the future of radiographers and sites, warranties requested. A confidential process approaching several buyers in parallel allows these offers to be compared on a like-for-like basis and strengthens the selling partners' negotiating position.

Public sources consulted

IGF et IGAS, Pertinence et efficience des dépenses de radiologie, rapport n° 2024-M-055-03 / 2024-079R2 (publié juillet 2025) : https://igas.gouv.fr/sites/igas/files/2025-07/2024-079R2%20Pertinence%20et%20efficience%20des%20d%C3%A9penses%20de%20radiologie.pdf (high reliability)
IGAS, Pertinence et efficience des dépenses de radiologie, présentation du rapport IGAS-IGF (15 juillet 2025) : https://igas.gouv.fr/pertinence-et-efficience-des-depenses-de-radiologie (high reliability)
Assemblée nationale, Question écrite n° 10644 sur les baisses de tarifs de l'imagerie médicale (28 octobre 2025) : https://questions.assemblee-nationale.fr/q17/17-10644QE.htm (high reliability)
Vidal, De nouvelles baisses de tarifs imposées aux radiologues en juillet après des négociations infructueuses (18 juin 2026) : https://www.vidal.fr/actualites/37951-de-nouvelles-baisses-de-tarifs-imposees-aux-radiologues-en-juillet-apres-des-negociations-infructueuses.html (good reliability)
Caducée, Radiologie : le rapport IGAS-IGF ravive les tensions entre rigueur budgétaire et accès aux soins (26 août 2025) : https://www.caducee.net/actualite-medicale/16633/radiologie-le-rapport-igas-igf-ravive-les-tensions-entre-rigueur-budgetaire-et-acces-aux-soins.html (good reliability)
ARS Île-de-France, Améliorer l'accès à l'imagerie diagnostique : l'ARS délivre 345 autorisations d'IRM et de scanners (23 octobre 2025) : https://www.iledefrance.ars.sante.fr/ameliorer-lacces-limagerie-diagnostique-sur-le-territoire-francilien-lars-ile-de-france-delivre-345 (high reliability)
Sénat, Rapport d'information sur la financiarisation de l'offre de soins, C. Imbert, B. Jomier, O. Henno (25 septembre 2024) : https://senat.fr/rap/r23-776/r23-7761.pdf (high reliability)
Xerfi, Quand le secteur de la radiologie se financiarise à vitesse grand V, avis d'expert (27 février 2025) : https://www.xerfi.com/blog/quand-le-secteur-de-la-radiologie-se-financiarise-a-vitesse-grand-v_1603 (high reliability)
Le Quotidien du Médecin, Imagerie médicale : la décision du Conseil d'État offre un cap clair, tribune du Dr Alain Dana (25 octobre 2024) : https://www.lequotidiendumedecin.fr/opinions/imagerie-medicale-la-decision-du-conseil-detat-offre-un-cap-clair-analyse-le-dr-alain-dana-president (moderate reliability)
AuntMinnie Europe, JFR: Private radiology group Vidi continues to expand (7 octobre 2024) : https://www.auntminnieeurope.com/resources/conferences/jfr/article/15705216/jfr-private-radiology-group-vidi-continues-to-expand (good reliability)