Radiology administrators remain confident that imaging will grow as a profit center in the coming months, yet concerns persist about Medicare reimbursement and rising operating costs.
The findings come from Ensolve Research’s (formerly The MarkeTech Group) Medical Imaging Confidence Index (MICI) third quarter 2026 report, which collected responses from 91 imaging directors and managers across the U.S. who rated their confidence across five practice areas.
“Confidence remains very high regarding monthly growth in study volume and the ability of departments to maintain/grow as a profit center,” the report stated. “Internal operating and staff costs and Medicare reimbursement remain the primary areas of concern, reflecting low confidence.”
The MICI is produced by Ensolve Research using its imagePRO panel of radiology administrators and business managers. Participants rate their confidence across five practice areas. Scores range from 0 to 200, with 90 to 110 considered neutral and 111–130 considered high confidence. By facility size, 46% of respondents reported 100 beds or fewer, 30% reported 100 to 299 beds, and 24% reported 300 beds or more.
For the third quarter of 2026 the report found the following, as compared to the fourth quarter of 2025:
MICI Q3 2026 confidence scores by topic | ||||
Topic | Mean score Q4 2025 | Interpretation | Mean score Q3 2026 | Interpretation |
Will maintain/grow as a profit center | 133 | Very high confidence | 137 | Very high confidence |
Will grow monthly in diagnostic and interventional radiology | 132 | Very high confidence | 132 | Very high confidence |
Will have access to capital for imaging equipment and IT needs | 103 | Neutral | 116 | High confidence |
Internal operating and staff costs will remain constant | 99 | Neutral | 88 | Low confidence |
Will receive adequate reimbursement from Medicare for diagnostic and interventional imaging | 78 | Low confidence | 81 | Low confidence |
Composite score across all areas | 109 | Neutral | 112 | High confidence |
"Overall confidence is high, having increased by 3 points since Q4 2025," the report stated.
By region, the Mid-Atlantic, South Atlantic, and East South Central regions posted the highest composite scores, each reflecting high or near-high overall confidence. By contrast, the West North Central region scored 94 (neutral) and reported very low confidence in Medicare reimbursement at 59. Six of eight regions maintained very high confidence in monthly volume growth.
By bed size, hospitals with 100+ beds saw a significant increase in confidence regarding access to capital for imaging equipment and IT needs, while hospitals with 100 to 299 beds expressed the lowest confidence regarding the stability of internal operating costs.
In addition, free-text responses from respondents pointed to supply chain pressures as a compounding factor alongside labor costs, with participants noting shortages in contrast media, gloves, needles, and biopsy supplies, according to the report.
Free-text comments also pointed to interventional radiology expansion as a potential growth driver, while others flagged persistent technologist and radiologist recruitment difficulty. Participants citing Medicaid cuts, and reduced grant and foundation funding for not-for-profit institutions as sources of concern.
"Medicare reimbursement is still inadequate," one respondent wrote. "Private pay has to carry them. Equipment, cost, and supplies are on the rise."
