Study Finds Geographic Distance Impacts Cardiovascular Imaging Access for Medicare

A recent study analyzing data from over 64 million older U.S. Medicare fee-for-service and Medicare Advantage beneficiaries from 2018 to 2021 examined the relationship between geographic distance to cardiovascular imaging centers (CVIC) and the receipt of cardiovascular imaging (CVI). The study found that while the number of CVICs increased slightly over the study period, the median distance beneficiaries lived from CVICs remained stable at approximately 3.3 to 3.4 miles. Interestingly, those living more than 16 miles from a CVIC had a slightly lower likelihood of receiving cardiovascular imaging compared to those living 10 to 16 miles away. However, the lowest likelihood of receiving imaging was for beneficiaries living within 10 miles of a CVIC, suggesting that proximity alone does not guarantee access or utilization of these services. The study differentiated between types of imaging modalities, noting that distances to advanced imaging services such as cardiac computed tomography (CCT), cardiac magnetic resonance (CMR), and positron emission tomography (PET) were notably greater than distances to more common modalities like echocardiography and single-photon emission computed tomography (SPECT). For example, median distances to PET services were up to 88.9 miles, reflecting concentration in large metropolitan academic centers. This geographic distribution of specialized services highlights potential access disparities based not just on distance but also on location and service availability. These findings have important implications for payer and provider strategies in improving diagnostic access and utilization among Medicare beneficiaries. Despite the small increase in available CVICs, stable spatial access metrics and uneven distribution of advanced imaging resources point to persistent geographic and possibly systemic barriers. Health systems and insurers may need to explore solutions beyond proximity, such as transportation support, telehealth imaging consultations, or expanded service networks, to increase cardiovascular diagnostic rates effectively. The research was peer-reviewed and published in JACC-Cardiovascular Imaging, involving contributors from Harvard Medical School and other academic institutions. The study adds to ongoing discourse on healthcare access inequalities, service distribution, and infrastructure planning in the cardiovascular imaging domain. For stakeholders in health insurance, regulated entities, and healthcare providers, integrating these insights may help in regulatory compliance, network adequacy assessments, and improving patient outcomes through better diagnostic coverage.