National Turnaround Time Trends for Medicare Fee-for-Service Beneficiaries, 2014-2023

To assess turnaround time trends for office and hospital outpatient imaging studies as an indication of the radiologist workforce's capacity to absorb the growing demand for diagnostic imaging.

This multiyear (2014-2023) retrospective study using claims from a 5% sample of Medicare fee-for-service beneficiaries evaluated days between office and hospital outpatient imaging (CT, MR, ultrasound, radiology or fluoroscopy) acquisition and its subsequent interpretation. Technical claims (imaging acquisition) were matched with professional claims for interpretation by beneficiary and procedure code to assess the calendar days between the scan and its interpretation. Annual turnaround times were assessed overall and by modality, patient, and radiologist characteristics and day of the week.

There were 2,578,953 imaging studies that met the selection criteria. There were 0.109 mean days to interpretation (95% confidence interval [CI]: 0.108-0.111) for the study period. In 2014, there were 0.091 (95% CI: 0.086-0.095) mean days to interpretation compared with 0.193 (95% CI: 0.0.189-0.198) in 2023-a 113% increase-with most of this increase occurring in 2022 and 2023. By modality, the 2014-2023 increases in turnaround times were 318%, 256%, 140%, and 63% for CT, MR, ultrasound, and radiology or fluoroscopy, respectively. These trends differed somewhat by community income, Area Deprivation Index, and urbanicity, with more disadvantaged communities generally having longer turnaround times.

Imaging interpretation turnaround times for Medicare fee-for-service beneficiaries steeply increased between 2021 and 2023, and particularly for CT and MR. The trend exacerbated already longer turnaround times in lower-income communities. These sudden increases suggest that the radiology workforce has reached maximum capacity.