Abstract 16291: Regional Variability in Cardiovascular MRI Access and Utilization in the U.S. Population From 2017 to 2019

Abstract

Background: Despite clinical guidelines and scientific data supporting the use of cardiovascular magnetic resonance (CMR) imaging in multiple applications, CMR continues to be underutilized in the United States (U.S.). Objective: This study aims to capture geographic variability, access, and CMR practice patterns in the U.S. between 2017 and 2019. Methods: Commissioned reports from the Society of Cardiovascular Magnetic Resonance (SCMR), and data from a nationwide survey of CMR centers were used. Medicare claims for CMR studies from 2019 were compiled by the Moran Company. Surveys designed to collect data on center-specific characteristics were sent to 155 CMR centers identified through SCMR email listserve and Medicare claims data. Survey responses were reviewed to ensure only one response was captured from each center. Results: A total of 592 imaging centers were included in the Moran report and 112 unique centers responded to the survey. Of the centers included in the report, 47% billed for less than 10 of the most frequent study (CMR for morphology w/ dye) in 2019. The total density of CMR centers was 15.6 centers per million U.S. Medicare Part B beneficiaries. CMR centers are more dense in geographic areas of lowest socioeconomic disadvantage (based on the Area Deprivation Index), low poverty, and lowest percent of people lacking health insurance. Sixty-eight percent of survey responders were cardiologists, and 28% were radiologists. Seventy-two percent of centers reported performing 81-100% of their CMR exams in an academic healthcare system. Centers performing >500 scans per year had an average of 19 years of experience, whereas centers performing <50 scans had an average 3.5 years’ experience. The most common response for approximate patient wait time for CMR was 2 weeks to 1 month (45% of responses). Conclusions: Although CMR volume is increasing in the U.S., CMR access continues to demonstrate marked geographic variability. While almost half of centers are performing just a handful of scans annually, the greatest volumes are noted in well-established programs with years of experience. Identification of specific barriers to CMR access will be useful for future advocacy efforts and quality improvement initiatives.