Regional variability of cardiovascular magnetic resonance access and utilization in the United States
ABSTRACT: Background: Clinical guidelines and scientific data increasingly support the appropriate use of cardiovascular magnetic resonance (CMR) . The extent of CMR adoption across the United States (US) remains unclear. This observational analysis aims to capture CMR practice patterns in the US....
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664724010883 |
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| author | Jennifer M. Li David R. Ho Nazia Husain Robert W. Biederman J. Paul Finn Anthon R. Fuisz Ibrahim M. Saeed Kim-Lien Nguyen |
| author_facet | Jennifer M. Li David R. Ho Nazia Husain Robert W. Biederman J. Paul Finn Anthon R. Fuisz Ibrahim M. Saeed Kim-Lien Nguyen |
| author_sort | Jennifer M. Li |
| collection | DOAJ |
| description | ABSTRACT: Background: Clinical guidelines and scientific data increasingly support the appropriate use of cardiovascular magnetic resonance (CMR) . The extent of CMR adoption across the United States (US) remains unclear. This observational analysis aims to capture CMR practice patterns in the US. Methods: Commissioned reports from the Society for Cardiovascular Magnetic Resonance (SCMR), pre-existing survey data from CMR centers, and socioeconomic and coronary heart disease data from the Centers for Disease Control and Prevention were used. The location of imaging centers performing CMR was based on 2018 Medicare claims. Secondary analysis was performed on center-specific survey data from 2017–2019, which were collected by members of the SCMR US Advocacy Subcommittee for quality improvement purposes. The correlation between the number of imaging centers billing for CMR services per million persons, socioeconomic determinants, and coronary heart disease epidemiology was determined. Results: A total of 591 imaging centers billed the Center for Medicare & Medicaid Services for CMR services in 2018 and 112 (of 155) unique CMR centers responded to the survey. In 2018, CMR services were available in almost all 50 states. Minnesota was the state with the highest number of CMR centers per million Medicare beneficiaries (52.6 centers per million), and Maine had the lowest (4.4 per million). The total density of CMR centers was 16 per million for US Medicare beneficiaries. Sixty-eight percent (83 of 112) of survey responders were cardiologists, and 28% (31/112) were radiologists. In 72% (71/112) of centers, academic health care systems performed 81%–100% of CMR exams. The number of high-volume centers (>500 scans per year) increased by seven between 2017 and 2019. In 2019, 53% (59/112) of centers were considered high-volume centers and had an average of 19 years of experience. Centers performing <50 scans had on average 3.5 years of experience. Approximate patient wait time for a CMR exam was 2 weeks to 1 month. Conclusion: Despite increasing volume and availability in almost all 50 states, CMR access remains geographically variable. Advocacy efforts to improve access and innovations that reduce imaging time and exam complexity have the potential to increase the adoption of CMR technology. |
| format | Article |
| id | doaj-art-2faf203f033c43a480f3aaf1aa92724f |
| institution | OA Journals |
| issn | 1097-6647 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-2faf203f033c43a480f3aaf1aa92724f2025-08-20T01:56:45ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472024-01-0126210106110.1016/j.jocmr.2024.101061Regional variability of cardiovascular magnetic resonance access and utilization in the United StatesJennifer M. Li0David R. Ho1Nazia Husain2Robert W. Biederman3J. Paul Finn4Anthon R. Fuisz5Ibrahim M. Saeed6Kim-Lien Nguyen7University of Arizona College of Medicine, Phoenix, Arizona, USA; David Geffen School of Medicine at UCLA, Los Angeles, California, USADavid Geffen School of Medicine at UCLA, Los Angeles, California, USALurie Children’s Hospital and Northwestern University School of Medicine, Chicago, Illinois, USAWest Virginia University, Morgantown, West Virginia, USA; Carnegie Mellon University, Pittsburgh, Pennsylvania, USA; Medical University of South Carolina and Roper St Francis Hospital, Charleston, South Carolina, USADavid Geffen School of Medicine at UCLA, Los Angeles, California, USAWestchester Medical Center, Valhalla, New York, USAVirginia Heart, Falls Church, Virginia, USA; Inova Schar Heart and Vascular, Fairfax, Virginia, USADavid Geffen School of Medicine at UCLA, Los Angeles, California, USA; VA Greater Los Angeles Healthcare System, Los Angeles, California, USA; Correspondence author. David Geffen School of Medicine at UCLA, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, MC 111E, Los Angeles, CA 90073, USA.ABSTRACT: Background: Clinical guidelines and scientific data increasingly support the appropriate use of cardiovascular magnetic resonance (CMR) . The extent of CMR adoption across the United States (US) remains unclear. This observational analysis aims to capture CMR practice patterns in the US. Methods: Commissioned reports from the Society for Cardiovascular Magnetic Resonance (SCMR), pre-existing survey data from CMR centers, and socioeconomic and coronary heart disease data from the Centers for Disease Control and Prevention were used. The location of imaging centers performing CMR was based on 2018 Medicare claims. Secondary analysis was performed on center-specific survey data from 2017–2019, which were collected by members of the SCMR US Advocacy Subcommittee for quality improvement purposes. The correlation between the number of imaging centers billing for CMR services per million persons, socioeconomic determinants, and coronary heart disease epidemiology was determined. Results: A total of 591 imaging centers billed the Center for Medicare & Medicaid Services for CMR services in 2018 and 112 (of 155) unique CMR centers responded to the survey. In 2018, CMR services were available in almost all 50 states. Minnesota was the state with the highest number of CMR centers per million Medicare beneficiaries (52.6 centers per million), and Maine had the lowest (4.4 per million). The total density of CMR centers was 16 per million for US Medicare beneficiaries. Sixty-eight percent (83 of 112) of survey responders were cardiologists, and 28% (31/112) were radiologists. In 72% (71/112) of centers, academic health care systems performed 81%–100% of CMR exams. The number of high-volume centers (>500 scans per year) increased by seven between 2017 and 2019. In 2019, 53% (59/112) of centers were considered high-volume centers and had an average of 19 years of experience. Centers performing <50 scans had on average 3.5 years of experience. Approximate patient wait time for a CMR exam was 2 weeks to 1 month. Conclusion: Despite increasing volume and availability in almost all 50 states, CMR access remains geographically variable. Advocacy efforts to improve access and innovations that reduce imaging time and exam complexity have the potential to increase the adoption of CMR technology.http://www.sciencedirect.com/science/article/pii/S1097664724010883Cardiovascular magnetic resonance imagingUtilizationImaging accessGeographic densityAdvocacyCost-effectiveness |
| spellingShingle | Jennifer M. Li David R. Ho Nazia Husain Robert W. Biederman J. Paul Finn Anthon R. Fuisz Ibrahim M. Saeed Kim-Lien Nguyen Regional variability of cardiovascular magnetic resonance access and utilization in the United States Journal of Cardiovascular Magnetic Resonance Cardiovascular magnetic resonance imaging Utilization Imaging access Geographic density Advocacy Cost-effectiveness |
| title | Regional variability of cardiovascular magnetic resonance access and utilization in the United States |
| title_full | Regional variability of cardiovascular magnetic resonance access and utilization in the United States |
| title_fullStr | Regional variability of cardiovascular magnetic resonance access and utilization in the United States |
| title_full_unstemmed | Regional variability of cardiovascular magnetic resonance access and utilization in the United States |
| title_short | Regional variability of cardiovascular magnetic resonance access and utilization in the United States |
| title_sort | regional variability of cardiovascular magnetic resonance access and utilization in the united states |
| topic | Cardiovascular magnetic resonance imaging Utilization Imaging access Geographic density Advocacy Cost-effectiveness |
| url | http://www.sciencedirect.com/science/article/pii/S1097664724010883 |
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