ACR wants Medicare to add more radiology measures in MIPS quality pay program

The American College of Radiology is urging Medicare to add more quality measures in the Merit-based Incentive Payment System. 

ACR recently submitted comments to the federal government, suggesting ways to improve MIPS, which rewards radiologists for improving care quality and reducing costs. Radiology advocates believe the value-based payment program needs more measures to support radiologists in meeting performance requirements. 

“No two diagnostic radiology practices are alike,” CEO Dana H. Smetherman, MD, MBA, MPH, wrote to the Centers for Medicare & Medicaid Services Jan. 17. “For instance, one breast imaging practice may be integral to a comprehensive cancer center, another may cover a regional hospital system with numerous sites, and a third may serve a broad, widely dispersed rural area. Given this variation, the current draft [MIPS Value Pathway] does not provide enough [Clinical Quality Measures] applicable or feasible for a substantial number of diagnostic radiology practices.” 

Smetherman said the limited scope of measures may present challenges to the specialty. Many practices rely heavily on Qualified Clinical Data Registry measures for success in MIPS. However, the “restricted” list of options would “disrupt practices workflows, impose additional burdens on human and cost resources, and exacerbate clinician stress and burnout.” 

ACR suggested four possible alternative measures, focused on clinical scenarios such as interpreting CTPA exams for pulmonary embolism and using the Thyroid Imaging Reporting and Data System (TI-RADS). You can find the full list and further details in the letter.

“By incorporating these measures, CMS would allow more diagnostic radiologists who are eligible clinicians to participate in in the [MIPS Value Pathway], address critical care gaps, minimize reporting burdens and align with activities outlined in the Improvement Activity section of the draft MVP,” Smetherman added. “CMS’ expansion of the [Qualified Clinical Data Registry] measure list would support a more comprehensive range of clinical scenarios, enabling radiology practices to align MVP participation with their unique community needs and ultimately improve patient care.” 

ACR also sent a second letter to CMS Jan. 24 focused on interventional radiology and its unique needs. Smetherman highlighted concerns with the selection of quality measures, with many applying “only to specific subsets of IRs.” Measures focused solely on dialysis, for example, ignore “large swaths” of IRs.

“ACR is aware of the efforts by the Society of Interventional Radiology to develop interventional radiology-specific measures,” Smeterhman wrote. “However, these measures will take time to develop due to the complexity and cost of the process. As such, we want to emphasize the importance of measures broadly applicable across different interventional radiology practice settings and subspecialties to ensure adequate reporting opportunities that meet volume requirements.” 

The college suggested 10 more IR-related alternative measures. These included documentation of current medications, unplanned hospital readmissions within 30 days of the procedure, surgical site infection, and osteoporosis management in women with fractures. You can find the full list and further details in the IR letter here.

ACR promoted its messages in a news announcement to members shared Feb. 7. If adopted, new MIPS Value Pathways would become effective for 2026 reporting.