New research demonstrates significant increases in radiology report turnaround times over a 10-year period for office and outpatient imaging performed for Medicare beneficiaries.
For the retrospective study, recently published in the Journal of the American College of Radiology, researchers reviewed data for 2,578,953 imaging studies performed for Medicare beneficiaries between 2014 to 2023. Nearly 60 percent of the studies were X-rays, 15.9 percent were computed tomography (CT), 12.9 percent were magnetic resonance imaging (MRI) and 11.5 percent were ultrasound imaging, according to the study.
While there wasn’t much variation overall between 2014 and 2021 with respect to mean turnaround times (0.1 vs. 0.104 days), the study authors found significant increases in 2022 and 2023. The 0.193 day mean turnaround time for radiology reports in 2023 represented a 113 percent increase from 2014, according to the researchers. The study authors added that 19 percent of the increase occurred in 2022 and 68 percent of the spike in turnaround times occurred in 2023.
“We found that most studies were interpreted on the same calendar day as the imaging study throughout our study. However, the share of studies interpreted a day or more later increased 2.5-fold over the study period,” noted lead study author Eric Christensen, Ph.D., the director of economic and health services research at the Harvey L. Neiman Policy Institute in Reston, Va., and colleagues.
Breaking the increased turnaround times down by imaging modality, the researchers noted:
• a 63 percent increase for X-rays
• a 140 percent increase for ultrasound exams
• a 256 percent increase for MRI assessment; and
• a 318 percent increase for CT interpretation.
“With growing (emergency department) imaging volumes, particularly multiplanar reformatted CT studies with comprehensive anatomical coverage that can take substantial time to interpret, and increasing images to interpret per study, the steep increases observed in this study suggest that volumes may have reached a tipping point such that the radiology workforce and current technology available to radiologists for reviewing imaging studies can no longer absorb continued volume growth,” posited Christensen and colleagues.
Three Key Takeaways
• Sharp post-2021 inflection in turnaround times. Mean report turnaround times were stable from 2014–2021 but rose dramatically in 2022–2023, with a 113 percent increase by 2023, signaling a potential capacity threshold in radiology workflow and staffing.
• Disproportionate delays in advanced imaging. Turnaround time increases were most pronounced for CT (318 percent) and MRI (256 percent), suggesting that growing study complexity and image volume—rather than just case counts—are key drivers of reporting delays.
• Worsening health equity gap. Reporting delays were consistently higher in lower-income communities and more than doubled in disparity (121 percent vs. 56 percent) in recent years, highlighting that workflow strain may be amplifying existing access and care inequities.
The study authors also pointed out an exacerbation of health equity challenges within the study findings. From 2014 to 2020, the researchers noted that turnaround times for radiology reports were 56 percent higher in the lowest income communities in comparison to the highest-income communities. This gap in turnaround times more than doubled to 121 percent for the 2021-2023 period of the study, according to the study authors.
“Access disparities in disadvantaged communities such as rural areas and low-income areas are well established. Our results point to potential secondary effects as increases in turnaround times worsened income-based gaps,” added Christensen and colleagues.
(Editor’s note: For related content, see “Emphasizing the Role of Interoperability in Improving Radiologist Workflow and Decision-Making in Rural Diagnostic Care,” “Radiology Workforce Study Finds Greater Attrition of Women, Subspecialists and Non-Academic Radiologists Over Eight-Year Period” and “The Inflection Point for AI in Radiology: Emerging Insights for 2026.”)
In regard to study limitations, the authors acknowledged the observational nature of the study and a lack of direct evidence (such as time stamps) that identifies when an imaging exam was performed and when the subsequent radiology report was completed.
