Are ancillary services now a loser?

It is no surprise that total medical revenue from 2009-2010 declined for many practices according to MGMA data. While the thinking has been that those with ancillary services would continue to outperform those without, this was not necessarily the case. Turns out that for PC practices the revenue per FTE physician declined regardless of ancillary revenue. Surprisingly, surgical practices without ancillaries did better than practices with ancillaries with some increase in revenue and profit. In contrast, those with ancillary services had decreases in both metrics. For multi-specialty groups there was a slight increase in total revenue and minimal increase in profits. 
Comment: I guess you have to wonder (without breaking down the numbers) whether this is due to decreased reimbursement (ultrasound for example) or continued rise in fixed expenses such as salary, benefits and bricks and mortar costs. Medicare is trying to fix leaks as they spring up and when the leak is a flood then they run to stop the leak. Soon, there is another leak. We will observe where the next one is. Unless, the entire reimbursement system is turned on its head.

Update:  11/30/2014; With the ACA, everything is on it's head!