AI Insights: Ready or Not …
By Jordan Bazinsky
Radiology Today
Vol. 26 No. 8 P. 8

Policy changes could challenge radiology’s balance of access, sustainability, and equity.

Radiology is bracing for the downstream impact of sweeping policy changes. Recent legislation and updates offer some near-term bright spots, such as modest telehealth expansions and a new Rural Health Transformation Fund, but significant challenges are also on the horizon. The projected loss of coverage for millions of people and steep reductions in Medicaid spending over the next decade are expected to have far-reaching effects. Radiology departments and imaging practices anticipate more late-stage diagnoses due to delays in preventive care, greater demand for emergency services, and payment reductions that force providers to operate on shrinking margins.

For radiologists, the dual challenge of delivering timely, high-quality care while maintaining financial and operational sustainability is likely to become more complex. If these pressures intensify strain and compound existing barriers, patient outcomes and health equity may suffer.

Preparing now for potential disruptions is critical. Imaging leaders who move to innovate with technology, optimize workflows for productivity, and advocate for patient-centered solutions will help ensure success for the industry and the patients who depend on it.

Contributing Factors
The impact of nearly 16 million Americans losing health care coverage combined with approximately $800 billion in federal funding cuts will affect radiology’s financial and clinical landscapes. The fallout that ensues will put immense pressure on patient access, provider sustainability, and health equity, eventually contributing to worsening health outcomes.

Uninsured patients are more likely to forgo or put off necessary preventive screenings and routine imaging. Postponing procedures often results in late stage diagnoses and strains hospitals as patients who could have initially been treated at outpatient centers finally seek immediate medical attention for worsening symptoms. When radiology experiences a change in referral patterns, clinicians typically see fewer scheduled mammograms or lung cancer screenings, followed by a surge in complex, urgent cases arriving through the emergency department (ED). The operational implications are significant.

Imaging departments facing unpredictable demand spikes feel the pinch in strained staffing models, scheduling systems, and modality utilization. They rely on balanced organizational and management processes to keep CT, MRI, and ultrasound running efficiently, but that stability breaks down when too many urgent or unscheduled procedures require clinicians’ attention. This new dynamic will disproportionately affect rural and underserved communities, where skewed provider-to-patient ratios have already left quality care in short supply.

Reduced imaging access in these areas is often the first consequence of financial pressure. Traveling farther for essential services is more than an inconvenience to many patients who don’t have the resources to overcome transportation barriers. Geography should not dictate the quality of health outcomes. But as financial pressures mount, smaller independent practices and rural health centers may be forced to limit services or close entirely. The resulting diagnostic deserts leave vulnerable populations with little choice but to seek late-stage care in EDs, which are already overburdened in certain areas. The 2024 Non-Urgent Use of Emergency Departments by Rural and Urban Adults study found that 16% of rural adults, compared with 13% of urban adults, reported visiting the ED.

Proactive Planning
From an operational standpoint, things unravel quickly once a precarious financial equation becomes unsustainable. An increase in uninsured and underinsured patients has experts projecting a $63 billion rise in uncompensated care costs for hospitals, which will unfold as providers grapple with declining and unequal reimbursement rates and tighter budgets. Higher operating costs and shrinking margins intensify existing provider challenges and force difficult decisions about technology investments, staffing levels, and service line expansions. Essentially, the mandate to provide high-quality care collides with the economic limitations standing in the way.

The palpable strain on the system will continue to erode access and equity unless action is taken to restabilize resources and provider support. Traditional models of operation weren’t built for the changes that are coming, so imaging leaders must start thinking differently to sustain them. The implementation of innovative strategies and tech-driven solutions can help providers protect their missions and their margins.

Maximizing productivity without compromising clinical quality is possible with advanced workflow orchestration and capacity-management tools that offer a real-time, enterprise-wide view of resources. Workloads that are well-balanced across sites and radiologists enable practices and imaging departments to optimize modality utilization and speed turnaround times. And as those improvements take hold, imaging leaders need to ensure their financial sustainability keeps pace. Diligent revenue cycle management is the key to accurate coding, fewer claim denials, and risk-based contracts that reward outcomes over volume.

Innovating With Technology
Technology has always provided an opportunity to evolve and advance through even the toughest challenges, and the imaging industry is on the cusp of one now. AI takes that promise further, with tools like AI-enabled worklists that automatically triage urgent cases so critical findings rise to the top and get read faster. AI can also strengthen quality assurance by serving as a second read, boosting diagnostic confidence and consistency. Yet at the core of this shift is something even more fundamental: the ability to share and access images across systems. Seamless interoperability delivers a complete view of a patient’s imaging history—no matter where the studies were performed—and is essential for timely, accurate diagnosis at any stage.

The imaging industry is at a critical point. Investments in advanced tools, including AI-powered solutions and interoperable platforms, will go a long way in protecting operations and enhancing efficiency amid ongoing turbulence. However, radiology’s role in building a more resilient and equitable health care system doesn’t end there.

Change is never easy, but it’s essential for industry transformation and can be made in manageable phases. A practical way to get started, for example, is to focus on three key areas, such as the application of new technologies, emphasizing integration across the care continuum, and prioritizing policies that link financial incentives to better patient outcomes. That first step may be small, but deliberate action and a shared commitment to progress will put timely, high-quality diagnostic care within every patient’s reach.