Temporal trends and geographic accessibility to cardiac magnetic resonance readers across the United States: an analysis of Medicare Part B data.

BACKGROUND

Cardiovascular magnetic resonance (CMR) has a growing role in the diagnosis and management of cardiac disease. However, there is little recent data on the availability of CMR physicians (readers) in the United States (US).

OBJECTIVE

To demonstrate the geographic proximity and accessibility of patients to CMR services and CMR physicians across the US.

METHODS

Using Medicare Part B data in 2022, we analyzed the number and characteristics of CMR readers, their geographical location, and the volume of CMR scans between 2013 and 2022. CMR procedure types were identified using healthcare common procedure coding system (HCPCS) codes 75557, 75559, 75561, and 75563.

RESULTS

Among Medicare beneficiaries in 2022, there were 48,622 CMR scans, up from 17,944 in 2013 (170.9% increase). The lowest scans and reader density were in West Virginia (125.8 procedures and 2.2 readers per million beneficiaries, respectively) and the highest in the District of Columbia (4566.5 procedures and 52.9 readers per million beneficiaries, respectively). No CMR scans were billed in Puerto Rico. Among states and territories that billed for CMR, 50.8 million U.S. citizens were located more than 50 miles from CMR readers and 18.1 million were located more than 100 miles away. Out of 991 readers, 51.9% were radiologists and 48.1% were cardiologists. The median number of scans interpreted by cardiologists was higher than radiologists across all graduation year intervals, and male and female readers interpreted a similar median number of scans. The relative proportion of female readers increased markedly when assessing physicians who graduated after 2010.

CONCLUSION

This study highlights significant geographic disparities and barriers to accessing CMR in the US.