RadNet has agreed to buy ONRAD, expanding into remote radiology interpretation and hospital staffing. The RadNet ONRAD deal calls for $350 million in cash and 5 million RadNet shares. The deal includes an additional payment of up to $210 million tied to future earnings. The companies expect to close the acquisition in early 2027, subject to regulatory review and other conditions. Until then, ONRAD will continue operating separately from RadNet.
ONRAD provides radiologists to interpret scans remotely and support hospitals on site. RadNet plans to build a third operating segment around those services, alongside its outpatient imaging and digital health businesses.
RadNet ONRAD Deal Adds Hospital Radiology Services
ONRAD works with more than 130 contracted radiologists. Its services support over 225 hospital facilities across 26 states, according to RadNet. The company also serves imaging centres and other healthcare providers.
The business offers remote final interpretations and in-hospital staffing, including interventional radiology coverage. Its teleradiology services include final reads and preliminary reports around the clock from U.S.-based radiologists. This gives RadNet a different business model from its imaging centres. ONRAD primarily supplies image interpretation and professional staffing services rather than operating imaging facilities.
Cash, Shares and an Earnout
The agreement combines a fixed payment with additional consideration based on ONRAD’s performance. Its principal terms are:
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$350 million in cash at closing
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5 million shares of RadNet common stock
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Up to $210 million in additional earnout value
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Earnout tied to ONRAD’s 2027 adjusted EBITDA target
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Closing expected in early 2027, subject to conditions
RadNet’s deal announcement says the earnout may be settled in cash, shares or both. The initial payment is therefore not the full potential consideration. RadNet projects ONRAD will add $190 million to $200 million in revenue during its first year after closing. It also forecasts adjusted EBITDA of $60 million to $65 million. These figures are management estimates, not guaranteed results.
Hospitals Face a Radiology Coverage Problem
RadNet says demand for imaging is growing faster than the supply of trained radiologists. That imbalance can make it difficult for hospitals to staff overnight shifts and deliver timely interpretations.CEO Howard Berger said hospital requests for staffing help influenced the decision to enter professional radiology services. He said the demand wasn’t limited to imaging equipment or software.ONRAD already provides remote interpretation and physicians to hospitals. RadNet expects those capabilities to help its existing hospital partners address coverage gaps without relying solely on local recruitment.
The company says ONRAD has reported annual revenue growth of 10% to 20% in recent years. Its adjusted EBITDA margins have exceeded 30%, according to RadNet. Those historical figures do not guarantee similar growth after the takeover.
RadNet Plans to Link Radiologists and Imaging AI
RadNet operates DeepHealth, a digital health business focused on imaging software and artificial intelligence. It expects ONRAD’s radiologists to complement that technology and its outpatient imaging operations. A wider shift toward medical imaging AI is already changing how scans are produced and reviewed. Some systems assist with image measurements, processing, or workflow prioritisation, while physicians remain responsible for clinical interpretation.
RadNet’s proposed integration is a business plan, not a demonstrated improvement in hospital performance. Whether it can shorten reporting delays or improve coverage will depend on post-close implementation.
A Third Segment With Room to Expand
ONRAD would become the foundation of RadNet’s Radiology Professional Services segment. The company would then report businesses spanning imaging centres, DeepHealth and professional radiology services.
RadNet views the market as fragmented and sees scope for further acquisitions. ONRAD previously bought another provider, acquiring Direct Radiology from Philips.
AI used within a scanner differs from software used during image interpretation. TechAmerica’s reporting on Philips Verida describes AI-supported CT image reconstruction, a separate step from the radiology readings ONRAD provides. The combined business could offer services across hospitals, outpatient sites, physician offices and urgent care facilities. Those plans remain subject to the acquisition closing and subsequent integration.
Closing and Integration Remain Ahead
The RadNet ONRAD deal has not yet closed. Regulators must review the transaction, and both companies must satisfy the remaining conditions. If completed, the acquisition would give RadNet a network of radiologists and an established hospital services platform. It would also expose the company to the operational demands of professional staffing, beyond its existing imaging centres. RadNet’s financial projections depend on retaining customers and integrating the operations effectively. The MedTech Dive report also examined hospital demand for radiology coverage and thecompany’ss acquisition strategy.
