Turnaround times for interpreting outpatient imaging studies more than doubled between 2014 and 2023, according to a new analysis from the Harvey L. Neiman Health Policy Institute, highlighting growing strain on radiology capacity.

The study, published in the Journal of the American College of Radiology, reviewed Medicare fee-for-service claims covering 2.6 million office- and hospital-based outpatient imaging exams. Researchers found that average turnaround times remained relatively stable from 2014 through 2021 before rising sharply in the following two years. Of the total increase observed over the study period, 19% occurred in 2022 and 68% in 2023.

“Visually, the increase in turnaround times looks like a hockey stick. It is generally flat with annual fluctuations from 2014 through 2021, and then it sharply increased beginning in 2022,” said Eric Christensen, research director at the Neiman Institute and lead author.
Across modalities, the largest increases were seen in CT (318%) and MR (256%), followed by ultrasound (140%) and radiography/fluoroscopy (63%).

The findings align with reports of workforce constraints in radiology. “The results show that an inflection point has occurred. Turnaround times were stable for many years and then doubled in two years,” said Dr. Greg Nicola, of Hackensack Radiology Group and study senior author.

The analysis focused on outpatient imaging, as inpatient and emergency department studies are typically prioritized for interpretation. Researchers noted that more recent data were not yet available but suggested the trend may reflect capacity limits being reached.

“Although anecdotal reports from frontline radiologists did not spike until 2025, the urgency presented by delayed diagnosis and treatment caused us to initiate the study with available data through 2023,” said Dr. Christoph Wald of the Mayo Clinic.

The study also identified disparities tied to community income. Patients in lower-income areas experienced longer turnaround times, with gaps widening over the study period. “While turnaround times increased for all income groups, they increased more for the low-income groups,” said Dr. Michele Johnson of Yale School of Medicine.

Researchers said the clinical impact of delays warrants close monitoring, particularly if imaging demand continues to grow.

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